integrated corporate performance report may 2017 · page 4 of 7 aqi metric jun-16 jul-16 aug-16...

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Integrated Corporate Performance Report

May 2017

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Introduction 1.

Following a request from the Trust Board, the format of the monthly Integrated Corporate 1.1.

Performance Report (ICPR) has been reviewed. This review has been completed with the assistance and input of Non-Executive Director representatives and other key stakeholders within the organisation. The proposed new style report encompassing the recommendations made is enclosed for review and comment.

The proposed new format of the ICPR includes: 1.2.

An Executive Summary limited wherever possible to four pages;

A RAG rating Dashboard providing an ‘at a glance’ overview of the key metrics;

A new Information Pack providing all of the key data and graphics detailing performance against the targets and KPIs identified by the Trust.

The Executive Summary highlights the key areas of note and interest to the Trust Board. It 1.3.

is intended that this will include details of any areas of significant exception where the Trust is either ‘off plan’ or below target, together with the key actions that are being taken to address the under-performance.

The Dashboard summarises the RAG ratings of the key metrics monitored by the Trust. In 1.4.

order to promote consistency these are ordered according to the key headings contained within the A&E (999) Operating Plan for 2017/18. The headings are as follows:

Clinical Quality and Patient Care;

Our People;

Operational Resources;

Productivity;

Performance;

Finance and Use of Resources and;

Activity.

The new Information Pack is a comprehensive data set which includes graphs and tables 1.5.

covering the full list of KPIs and metrics monitored by the Trust. It is intended that this will improve the efficiency of collecting and reporting information on a monthly basis and will also provide a clearer overview of the data available to the Trust Board and to members of the public that access the ICPR on line. Further, the Information Pack can be used by managers of the Trust to assist in preparing for meetings, managing performance within their area and compiling reports as appropriate.

Additional metrics will be added to the ICPR during 2017/18 including information in respect 1.6.

of Training Compliance and Infection Prevention and Control.

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A&E (999) Performance 2.

Incidents are 1.9% below contract in May 2017. When compared against the same period 2.1.

last year (May 2016) incidents are 0.24% higher.

The Trust is participating in the Ambulance Response Programme (ARP) trial which aims to 2.2.

improve response times to critically ill patients, making sure the best response is sent to each patient the first time with the appropriate degree of urgency. The ARP is at the end of its testing phase however it has been recommended that ambulance services continue to operate under ARP conditions until a national decision is made on full implementation. This is expected imminently.

The Sheffield School of Health and Related Research (ScHaRR) has prepared an 2.3.

evaluation report on ARP which is currently being considered by NHS England. More information from NHS England about the ARP trial can be found on their website: https://www.england.nhs.uk/ourwork/qual-clin-lead/arp/

The average response time for Category 1 (life threatening) incidents in May 2017 was 7.3 2.4.

minutes, with a 90th percentile response time of 12.9 minutes across the Trust. Of the 3,982 Category 1 incidents within the month 2,769 incidents (69.54%) received a response within 8 minutes.

The average Category 1 incident response times across the Trust continue to show 2.5.

expected variation, with the longest average response times in Cornwall (8.4 minutes) compared to the shortest time of 6.3 minutes in the more urban areas of Bristol and Swindon.

Following a review of the Trusts operational resources by ORH Ltd, Category 2 response 2.6.

times have been identified as the most challenging area for the Trust to deliver. The new rotas will improve the alignment of available resources to demand and will deliver a stepped improvement when they are all introduced and resourced across the Trust. The current average response time of 24.2 minutes (May 2017) and 90th percentile response time of 50.9 minutes are therefore where the Trust would expect the most significant improvement as a result of the rota and associated resource changes.

The North Division has already introduced their new rotas. Revised rotas for the East and 2.7.

West Divisions will go live at the beginning of July 2017. The full benefit of the rota changes across all the Divisions will only be fully realised when the recruitment plans deliver the required establishment levels within each of the operational areas to fill current vacancies within the rota patterns. In the interim the Trust is filling vacant shifts using overtime, bank shifts, available relief shifts and third party private resources where appropriate with the aim of delivering ‘core’ (100%) resourcing levels on a daily basis.

The Trust has identified the need to improve 999 call answering performance. In recent 2.8.

months the ‘Time to Answer Calls’ metric within the Ambulance Quality Indicators and the ‘Call Abandonment’ metric have shown some deterioration in performance, with 1.83% of calls abandoned in May 2017 compared to a local threshold of 1.50%.

https://www.england.nhs.uk/ourwork/qual-clin-lead/arp/

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AQI Metric Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17

50th

Percentile 2 2 2 3 2 2 2 2 2 2 2 2

95th

Percentile 66 84 74 74 75 26 61 39 26 47 55 64

99th

Percentile 129 140 143 159 157 80 135 95 76 102 114 144

Call advisor numbers in the Clinical Hub are currently below the funded establishment level 2.9.

and the Trust is undertaking an intense recruitment and associated training campaign to deliver the additional headcount required to fill the current vacancies. There is an ongoing challenge within the 999 telephony centre to meet the high levels of staff turnover (21.85% for the 12 months to May 2017). Call advisors within the Clinical Hub work in a stressful environment due to the nature of the calls they receive and they have a highly transferable skill set within the call centre market. Clinical Hub staff are therefore regularly leaving the service to work within the private sector for higher salaries and remuneration packages.

Recruitment of new call taking staff within the Clinical Hub has been successful and the new 2.10.

fully trained staff are expected to come out of their training courses and be added to call answering rotas by July 2017 bringing the Hub to its funded establishment levels. A business case for additional call advisors to increase the resilience within the Clinical Hub to manage peaks in demand was also presented to the Senior Leadership Team for consideration on 13 June 2017.

As well as the recruitment plans for 2017/18, the Trust is also looking at ways to improve 2.11.

staff retention levels both within the Clinical Hub and within the ambulance service as a whole in an attempt to reduce the current high levels of turnover reported, particularly within the telephony centres across the Trust.

Clinical cover within the Clinical Hub is also being reviewed and revised rota patterns for the 2.12.

Clinical staff are being discussed with Working Time Solutions to identify possible options during June 2017.

The current pressures within the Clinical Hubs regarding resourcing are also seen as a 2.13.

contributory factor to the higher levels of sickness reported within this area of the Trust.

Ambulance Clinical Quality Indicators 3.

The Trust is currently below (worse than) the local thresholds on a number of the 3.1.

Ambulance Clinical Quality Indicators (ACQI). Performance for these metrics is reported on a different timeline to other data included within this report, with data captured retrospectively due to the nature of the metrics covered. Data within this report includes performance up to and including January 2017.

ACQI – Outcome from Cardiac Arrest – Return of Spontaneous Circulation (ROSC) The Research, Audit and Quality Improvement Team have completed the introduction of the 3.2.

Cardiac Arrest checklist, in line with our stated aims in the Cardiac Arrest Indicator as set out in the Trust Quality Account. Cardiac arrest is one of the Medical Directorate priority

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plans for 2017/18, with a comprehensive action plan and dedicated management lead. The overall aim is to improve survival to discharge and therefore ROSC.

ACQI – Acute STEMI – Patients Receiving Primary Angioplasty within 150 minutes and ACQI – Outcome from Stroke for Ambulance Patients – Patients Receiving Thrombolysis at a Hyper-acute Centre within 60 minutes

The Clinical Quality Improvement Team delivered the ‘RAPID’ initiative, collaboratively 3.3.

working with the Operations Directorate. The project has now concluded, and resulted in a 7% improvement in the number of patients achieving the target. The RAPID metric is now part of the new KPI Performance Scorecard for Operational Managers which was launched for testing by senior managers in May 2017.

ACQI – Outcome from Acute STEMI – Patients Receiving Appropriate Care Bundle Feedback from the Quality Improvement collaborative work with internal stakeholders 3.4.

indicates that the decrease in pain scoring may be due in part to the lack of familiarity with how to record this on the electronic patient record. The next ECS release will include a change to make AQI Care Bundle fields mandatory, which will ensure that performance against the metric immediately increases.

ACQI – Outcome from Cardiac Arrest – Survival to Discharge The Clinical Quality Improvement Team has initiated a programme of Quality Improvement 3.5.

work aiming to improve the Trust performance against this metric, as detailed under the ROSC indicator.

GP Out of Hours Service Performance (GP OOH) 4.

The Gloucestershire GP OOH service transferred to a new provider on 1 June 2017 and 4.1.

therefore the information contained within this report will be the final figures for this service.

The Quality Requirements relating to Urgent Treatment Centre appointments and Urgent 4.2.

Home Visits remain the greatest challenge for the Dorset GP OOH service. The Trust has not been able to deliver these standards consistently.

In May 2017 the Dorset GP OOH service was partially compliant against the Urgent 4.3.

Treatment Centre appointment standard (93.3% compared to the target of 95%). The Trust is missing the target by 2 to 3 urgent cases per week of which the majority are ‘missed’ at the weekend. Operational Managers are undertaking a review of resources at the treatment centres to identify any improvements to performance that can be delivered within the current available funding.

The Trust was non-compliant for Urgent Home Visits May 2017 with 296 of the 338 visits 4.4.

completed within the 2 hour urgent target (87.6% compared to the target of 95%). Whilst it is acknowledged that home visits are more difficult to target in view of the large geographical spread of a relatively low number of urgent incidents, operational managers are undertaking a review of historic activity and activity profile to review the alignment of available mobile resources. The report summarising the findings of this review is expected to be presented to Directors at the end of June 2017 and a summary of the identified actions will be included within the June 2017 Integrated Corporate Performance Report.

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Following the transfer of the Gloucestershire GP OOH service to a new provider the Staff 4.5.

Appraisal figures will be reviewed and re-calculated for the next ICPR to reflect the staff remaining in Dorset. The revised appraisal rate will be confirmed and local managers will be asked to confirm their plans to prioritise any member of staff who has not had an appraisal within the last 12 months.

NHS 111 Performance 5.

NHS 111 Call Answering performance during May 2017 was below the national target 5.1.

levels, with 83.44% of calls answered in 60 seconds in Dorset and 81.08% in Cornwall.

Whilst performance remains below the target levels, call answering is now more consistent 5.2.

across both services and is delivered above 80% on a weekly basis. The shortfall in current performance is attributed to vacancies within both the full and part time rota patterns within both contracts and these vacancies are being targeted with through recruitment.

The most difficult periods are weekends and Bank Holidays when call volumes have very 5.3.

short periods of high demand. The Trust has targeted recruitment of part-time staff to work specifically during these periods but high levels of turnover within this staff group remain of concern. Staff turnover rates of 38% have been reported for the past 12 months.

To recruit and train an NHS Pathways Call Advisor is currently an 6 to 8 week process 5.4.

(depending on whether the course is full or part time) and therefore maintaining the required recruitment campaign to meet this level of staff attrition is a challenge within the Trust, increased by the requirement for these new starters to work within very specific time periods to meet the peak demands within the service.

Encouragingly the Trust regularly reports weekday performance above 95%in both Dorset 5.5.

and Cornwall and call abandonment rates are now consistently below the target level of 5% each month.

Urgent Care Centre (Tiverton) Performance 6.

The primary performance measure within the contract is the 4 hour waiting time standard 6.1.

(this is the same target for acute trust Emergency Departments). In May 2017, 1,376 of the 1,385 patients were seen within 4 hours giving performance of 99.35% against 95% performance target. This performance above target levels has been delivered consistently along with a local standard to triage patients within 15 minutes. In May 2017, 98.81% of patients were triaged in 15 minutes.

Finance and Use of Resources 7.

NHSI introduced the Single Oversight Framework from 1 October 2016 and the Trust is 7.1.

assessed against the Use of Resource Metric which replaced the Financial Sustainability Risk Rating. Under the Use of Resource Metric the best score is 1 and the worse score is 4. As the Trust has not accepted its control total for 2017/18 the highest score the Trust can achieve is a 2.

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The Trust delivered a Use of Resource Metric of 2 at the end of May 2017. The score of 2 is 7.2.

based on the Trust delivering against the control total derived by NHS Improvement from the Trust financial plan.

The financial information is based on the second month of the financial year and includes 7.3.

the actual and year end forecast position for the Trust against the 2017/18 Financial Plan:

The Trust delivered a breakeven position at the end of May 2017, this position includes an under spend on basic pay relating to vacancies which has been offset by the use of overtime, agency and third parties;

The annual Cost Improvement target for 2017/18 is £10,466k and the Trust is forecasting delivery;

The Capital Plan for 2017/18 is £13,381k. The month two position shows an actual position of £2,542k compared to a plan of £2,646k (96%);

The Trust cash position at the end of May 2017 is £23,187k;

The Trust has been set an annual agency spend cap of £9,900k by NHS Improvement. The Trust year to date agency spend is £59k.

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Appendix A: ICPR Dashboard – May 2017

Clinical Quality & Patient Care Our People Operational Resources Productivity Performance Finance & Use of Resources Activity

AQI ROSC following Cardiac Arrest is above (better than) the local threshold (all patients and the Utstein Comparator Group).

AQI Re-Contact rates below (better than) the local threshold for incidents closed following treatment at scene and for incidents closed with telephone advice.

AQI Calls Closed with Telephone Advice is above (better than) the local threshold.

Establishment Levels are in line with the A&E Operating Plan forecast.

The forecast is being refreshed for end Q1 to account for an improving position. This will include the acceleration of ECA recruitment in the North.

Graduate Recruitment for 2017/18 has been more successful than planned, with 121 successful applicants to date (25 West, 41 North, 55 East) and a further 22 currently in assessment.

New Operational Rotas were implemented in the North Division from 3 April 2017.

East and West Division rotas are on schedule to be implemented at the beginning of July 2017 in line with the A&E Operating Plan.

A&E Frontline Sickness is showing an overall improvement compared to last year and is below the 5% target.

Hear & Treat Rates are above (better than) AQI local threshold levels.

Further improvements are expected as a result of improved Clinician cover in the Clinical Hubs from Q2 onwards as part of the A&E Operational Plan.

ARP response protocols have reduced the average number of resources arriving at scene per incident.

The new online KPI Scorecard for Operational Managers was launched at the end of May 2017 and will be rolled out to the Heads of Operations during June 2017 for testing and feedback.

NHS 111 Call Abandonment rates were lower (better) than the 5% target level.

Tiverton Urgent Care Centre continues to performance better than 95% for the 4 hour A&E standard and 15 minute triage metrics.

Financial year-end forecast at the end of May 2017 remains in line with Trust financial plans.

CIP plans remain on target at the end of May 2017.

Capital Expenditure is on plan at the end of May 2017.

The GP Out of Hours contract for Gloucestershire was transferred successfully to the new provider on 1 June 2017.

A&E incidents were 1.91% below contract in May 2017.

The YTD position is 1.60% below contract.

Compared to the same month last year activity was 0.24% higher.

AQI Calls Managed without Conveyance to an Emergency Department is above (worse than) the local threshold but SWASFT is currently the best performing ambulance trust in England against this metric.

Right Care: Non-Conveyance to ED is below 2016/17 outturn levels however the Trust continues to report the highest (best) non conveyance rates amongst ambulance trusts in England for the current AQI metrics.

Training data will be incorporated into future reports to identify progress against the Trust Training Plans for 2017/18.

The Training Plan for 2017/18 has been agreed; the headlines are set out within the A&E Operating Plan and this is what will be used for monitoring purposes.

Consultation within the East and West Divisions has resulted in some changes to the rota recommendations.

The Trust is currently awaiting outputs from ORH modelling to identify the extent of the impact of these changes on performance.

The expectation remains that the Divisions ‘make up’ any performance deficit arising as a result of changing rotas away from the recommendations.

All ORH resource modelling will be subject to a ‘refresh’ at the end of Q1 of 2017/18.

On Scene times and Wrap Up time improvements are expected as per the A&E Operating Plan for 2017/18.

New performance management reports were introduced in March 2017 to assist local operational managers in benchmarking performance, identifying best practice and identifying individual outliers.

Performance within this report is provided against the expected AQI performance metrics under ARP. These metrics are subject to confirmation within the national AQI Guidance documentation expected during Q1 of 2017/18.

ORH resource modelling has identified the challenge to deliver performance metrics for Category 2 incidents.

Out of Hours Service performance in Dorset for Urgent Home Visits and Urgent Treatment Centre Appointments were partially compliant in May 2017.

Resource profiles in the East and West Divisions are based on historic activity volumes and profiles and therefore resource profiles will not be at their optimum level (and meeting demand) until the rota changes have been completed at the beginning of July.

Until this time there is a ‘miss-match’.

AQI STEMI PPCI patients receiving angioplasty within 150 minutes is below (worse than) the local threshold.

AQI Stroke patients receiving thrombolysis at hyper-acute centre within 60 minutes is below (worse than) the local threshold.

AQI STEMI patients receiving an appropriate care bundle is below the local threshold.

AQI Stroke patients (assessed face to face) receiving an appropriate care bundle is below local threshold.

AQI Cardiac Arrest Survival to Discharge rate is below local threshold (all patients and the Utstein Comparator Group).

Appraisals are below the Trust target level of 85%.

The GP Out of Hour’s service is identified in this Report as an outlier against this metric. This position will be reviewed following the transfer of the Gloucestershire contract to new providers at the end of May 2017.

The current under establishment (in line with forecast) in the North is impacting on the ability to deliver consistent resourcing to meet the new rota schedules in full on a daily basis.

Performance is based on a 98% minimum rota fill.

Mitigation includes overtime, agency and third party use until recruitment fills vacancies.

Sickness levels in the A&E Clinical Hubs and in the West Division are identified as exceptions in this Report. This is a priority area to be addressed due to the direct impact on available resource hours.

Handover Delays, whilst showing improvements compared to the same period last year, remain high and impact directly on the number of resources available.

Improvement plans and trajectories are being discussed locally by Operational Managers with each hospital during Q1 of 2017/18.

Each STP is inserting a specific target around handover delays over 15 minutes within their plans. This will be closely monitored by the Trust going forward.

The Director of Operations will be changing the SOP escalation arrangements.

Category 1 performance (% of responses within 8 minutes) was below the 75% target in May 2017. Implementation of the revised rota patterns across all 3 Divisions is a key enabler required to deliver improvements in response times during 2017/18.

AQI Call Abandonment and Time to Answer Call metrics were above local thresholds in May 2017. Improvements in call answering performance is anticipated from July 2017 onwards.

NHS 111 Call Answering performance in May 2017 was below national performance targets.

There is considerable variation is CCG activity levels.

North Somerset CCG is 2.94% above contract in the first two months of the year.

The other two CCGs with activity above plan are Wiltshire (0.91%) and Bristol (0.07%).

At the other end of the scale Somerset CCG is 5.47% below contract Dorset is 4.17% below.

Appendix B:


Information Pack

May 2017

Integrated Corporate Performance Report - April 2017 1

Target/

KPIYTD Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18

7,690 3,708 3,982

5,411 2,642 2,769

75.0% 70.36% 71.25% 69.54%

75.00% 75.00% 75.00% 75.00% 75.00% 75.00% 75.00% 75.00% 75.00% 75.00% 75.00% 75.00%

YTD Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18

77.03% 76.24% 77.78%

80.57% 81.73% 79.40%

72.60% 75.40% 70.27%

72.36% 74.45% 70.14%

60.82% 62.18% 59.49%

63.29% 62.54% 63.99%

75.17% 76.71% 73.65%

65.17% 63.59% 66.59%

75.65% 74.14% 76.95%

72.32% 75.00% 69.34%

80.70% 83.46% 78.69%

68.71% 71.30% 66.26%

70.36% 71.25% 69.54%Trust Total

Gloucestershire CCG

Kernow CCG

NEW Devon CCG

North Somerset CCG

Somerset CCG

South Devon & Torbay CCG

South Gloucestershire CCG

Swindon CCG

Wiltshire CCG

ARP - Performance Metrics - Category 1 Performance %

Number of Category 1 Incidents Requiring a Response

Number of Category 1 Incidents Receiving a Response Within 8 Minutes

Percentage of Category 1 Incidents Receiving a Response Within 8 Minutes

ARP - Performance Metrics - Category 1 Performance % by CCG

Bath & North East Somerset CCG

Bristol CCG

Dorset CCG

71.25%

69.54%

0

500

1,000

1,500

2,000

2,500

3,000

3,500

4,000

4,500

50.00%

55.00%

60.00%

65.00%

70.00%

75.00%

80.00%

Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18

Category 1 Incidents - % Receving a Response Within 8 Minutes

Number of Category 1 Incidents Percentage of Category 1 Incidents Receiving a Response Within 8 Minutes Target

77.03%

80.57%

72.60%

72.36%

60.82%

63.29%

75.17%

65.17%

75.65%

72.32%

80.70%

68.71%

40% 45% 50% 55% 60% 65% 70% 75% 80% 85% 90%


Bristol CCG

Dorset CCG

Gloucestershire CCG

Kernow CCG

NEW Devon CCG

North Somerset CCG

Somerset CCG



Swindon CCG

Wiltshire CCG

Category 1 Performance % by CCG Year to Date


Target/


7.3 7.2 7.3

12.7 12.6 12.9

23.5 22.7 24.2

49.2 47.6 50.9

46.0 43.8 48.1

104.5 99.0 110.5

78.9 76.6 81.0

173.9 170.9 177.3

58.32% 60.63% 56.16%

7.5 7.5 7.5 7.5 7.5 7.5 7.5 7.5 7.5 7.5 7.5 7.5

15 15 15 15 15 15 15 15 15 15 15 15

18 18 18 18 18 18 18 18 18 18 18 18

36 36 36 36 36 36 36 36 36 36 36 36

45 45 45 45 45 45 45 45 45 45 45 45

90 90 90 90 90 90 90 90 90 90 90 90

90 90 90 90 90 90 90 90 90 90 90 90

180 180 180 180 180 180 180 180 180 180 180 180

Category 2 Response Time - Mean (minutes)

Category 2 Response Time - 90th Percentile (minutes)



ARP - Performance Metrics



Category 4 (999) Response Time - Mean (minutes)

Category 4 (999) Response Time - 90th Percentile (minutes)

% of Healthcare Professionals that receive a response within a agreed time window

(1, 2, 3 or 4 hours in length depending on acuity)

0.0

2.0

4.0

6.0

8.0

10.0

12.0

14.0

16.0


Category 1 Response Times (minutes)

0.0

10.0

20.0

30.0

40.0

50.0

60.0



0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

100.0

110.0

120.0



0.0

20.0

40.0

60.0

80.0

100.0

120.0

140.0

160.0

180.0

200.0


Category 4 (999) Response Times (minutes)



209 101 108

803 405 398

1,241 565 676

709 364 345

781 386 395

1,283 622 661

294 146 148

781 368 413

501 232 269

289 152 137

316 133 183

473 230 243

7,690 3,708 3,982


6.6 6.5 6.6

6.2 6.2 6.3

7.0 6.7 7.3

7.1 6.7 7.5

8.3 8.2 8.4

8.1 8.1 8.1

6.6 6.5 6.6

7.5 7.7 7.4

6.7 6.8 6.6

6.9 6.6 7.1

6.2 6.2 6.3

7.6 7.5 7.6

7.2 7.2 7.3


9.6 9.3 10.2

9.8 9.7 9.8

11.8 11.4 12.4

12.3 11.8 12.9

15.2 14.8 15.8

14.2 14.2 14.1

10.8 10.3 11.1

14.0 14.6 13.5

10.7 10.8 10.7

11.8 11.8 11.6

9.8 9.8 9.7

15.5 14.5 16.0

12.6 12.6 12.9

Trust Total

Category 1 90th Percentile Response Times by CCG

Wiltshire CCG

Trust Total

Swindon CCG

Dorset CCG

Gloucestershire CCG

Kernow CCG

NEW Devon CCG


Bristol CCG

Dorset CCG

Gloucestershire CCG

Kernow CCG

NEW Devon CCG

North Somerset CCG

Somerset CCG



Bristol CCG

Trust Total

Category 1 Number of Category 1 Incidents by CCG


Bristol CCG

Dorset CCG

Gloucestershire CCG

Kernow CCG

NEW Devon CCG

North Somerset CCG

Somerset CCG



Swindon CCG

Wiltshire CCG

Category 1 Mean Response Times by CCG


North Somerset CCG

Somerset CCG



Swindon CCG

Wiltshire CCG


Target/


1.50% 1.60% 1.37% 1.83%

3 2 2

19 55 64

60 114 144

11.00% 10.68% 11.06% 10.32%

5.50% 4.65% 4.50% 4.80%

7.50% 14.48% 14.48% 14.48%

52.00% 49.18% 49.07% 49.28%

3 3 3 3 3 3 3 3 3 3 3 3

19 19 19 19 19 19 19 19 19 19 19 19

60 60 60 60 60 60 60 60 60 60 60 60

1.50% 1.50% 1.50% 1.50% 1.50% 1.50% 1.50% 1.50% 1.50% 1.50% 1.50% 1.50%

11.00% 11.00% 11.00% 11.00% 11.00% 11.00% 11.00% 11.00% 11.00% 11.00% 11.00% 11.00%

5.50% 5.50% 5.50% 5.50% 5.50% 5.50% 5.50% 5.50% 5.50% 5.50% 5.50% 5.50%

7.50% 7.50% 7.50% 7.50% 7.50% 7.50% 7.50% 7.50% 7.50% 7.50% 7.50% 7.50%

52.00% 52.00% 52.00% 52.00% 52.00% 52.00% 52.00% 52.00% 52.00% 52.00% 52.00% 52.00%

Ambulance Quality Indicators

Time to Answer Calls - Median (Seconds)

Time to Answer Calls - 95th Percentile (Seconds)


Re-Contact Rate Following Discharge of Care (unplanned re-contact with the ambulance service

within 24 hours of discharge of care by clinical telephone advice)


within 24 hours of discharge of care following treatment at scene)

Ambulance calls closed with telephone advice or managed without transport to A&E departments

(where clinically appropriate) - calls closed with telephone advice


(where clinically appropriate) - incidents managed without the need for transport to A&E

Call Abandonment Rate (% of calls abandoned before answering)

0

20

40

60

80

100

120

140

160


Time to Answer Calls (seconds)

Median 95th Percentile 99th Percentile

4.00%

5.00%

6.00%

7.00%

8.00%

9.00%

10.00%

11.00%

12.00%


Re-Contact Rate within 24 hours Following Discharge of Care by Clinical Telephone Advice

Re-Contact Rate Local Threshold

0.00%

1.00%

2.00%

3.00%

4.00%

5.00%

6.00%

7.00%

8.00%


Re-Contact Rate within 24 hours of Discharge of Care Following Treatment at Scene

Re-Contact Rate Local Threshold

0.00%

0.50%

1.00%

1.50%

2.00%

2.50%

3.00%


Call Abandonment %

Call Abandonment Rate (% of calls abandoned before answering) Local Threshold

0.00%

2.00%

4.00%

6.00%

8.00%

10.00%

12.00%

14.00%

16.00%


% of Ambulance Calls Closed with Telephone Advice

% Calls Closed with Telephone Advice Local Threshold

36.00%

38.00%

40.00%

42.00%

44.00%

46.00%

48.00%

50.00%

52.00%

54.00%


% of Ambulance Incidents Managed Without the Need for Transport to A&E

% Incidents Managed without Conveyance to A&E Local Threshold


PeriodNational

Average

East

Midlands

East of

EnglandLondon North East North West

South

Central

South East

Coast

South

Western

West

MidlandsYorkshire

Apr-17 0.74% 0.45% 0.76% 0.67% 0.57% 1.21% 0.17% 1.32% 1.37% 0.40% 0.25%

Apr-17 n/a 2 1 0 1 1 3 3 2 1 1

Apr-17 n/a 26 7 2 19 28 5 31 55 3 5

Apr-17 n/a 75 63 52 72 98 40 89 114 30 45

Apr-17 6.53% 0.85% 9.39% 3.31% 13.11% 4.32% 12.71% 6.82% 11.06% 13.83% 3.75%

Apr-17 5.12% 5.10% 5.62% 8.54% 4.73% 3.24% 4.19% 5.41% 4.50% 6.69% 1.07%

Apr-17 9.87% 18.23% 9.04% 10.70% 7.31% 8.54% 11.73% 6.48% 14.48% 4.81% 8.28%

Apr-17 36.99% 22.79% 37.42% 37.46% 36.09% 32.17% 40.08% 47.53% 49.07% 38.27% 30.22%

3 3 3 3 3 3 3 3 3 3 3 3

19 19 19 19 19 19 19 19 19 19 19 19

60 60 60 60 60 60 60 60 60 60 60 60

1.50% 1.50% 1.50% 1.50% 1.50% 1.50% 1.50% 1.50% 1.50% 1.50% 1.50% 1.50%

11.00% 11.00% 11.00% 11.00% 11.00% 11.00% 11.00% 11.00% 11.00% 11.00% 11.00% 11.00%

5.50% 5.50% 5.50% 5.50% 5.50% 5.50% 5.50% 5.50% 5.50% 5.50% 5.50% 5.50%

7.50% 7.50% 7.50% 7.50% 7.50% 7.50% 7.50% 7.50% 7.50% 7.50% 7.50% 7.50%

52.00% 52.00% 52.00% 52.00% 52.00% 52.00% 52.00% 52.00% 52.00% 52.00% 52.00% 52.00%

Ambulance Quality Indicators - National Benchmarking

Call Abandonment Rate (% of calls abandoned before answering)

Time to Answer Calls - Median (Seconds)




within 24 hours of discharge of care by clinical telephone advice)


within 24 hours of discharge of care following treatment at scene)


(where clinically appropriate) - calls closed with telephone advice


(where clinically appropriate) - incidents managed without the need for transport to A&E

0.74%

0.45%

0.76%

0.67%

0.57%

1.21%

0.17%

1.32%

1.37%

0.40%

0.25%

0.00% 0.20% 0.40% 0.60% 0.80% 1.00% 1.20% 1.40% 1.60%

National Average

East Midlands

East of England

London

North East

North West

South Central

South East Coast

South Western

West Midlands

Yorkshire

Call Abandonment %

26

7

2

19

28

5

31

55

3

5

0 10 20 30 40 50 60

National Average

East Midlands

East of England

London

North East

North West

South Central

South East Coast

South Western

West Midlands

Yorkshire

Time to Answer Call - 95th Percentile (seconds)

6.53%

0.85%

9.39%

3.31%

13.11%

4.32%

12.71%

6.82%

11.06%

13.83%

3.75%

0.00% 5.00% 10.00% 15.00%

National Average

East Midlands

East of England

London

North East

North West

South Central

South East Coast

South Western

West Midlands

Yorkshire

Re-Contact Rate within 24 hours Following Discharge of Care by Clinical Telephone Advice

5.12%

5.10%

5.62%

8.54%

4.73%

3.24%

4.19%

5.41%

4.50%

6.69%

1.07%

0.00% 2.00% 4.00% 6.00% 8.00% 10.00%

National Average

East Midlands

East of England

London

North East

North West

South Central

South East Coast

South Western

West Midlands

Yorkshire

Re-Contact Rate within 24 hours Following Discharge of Care Following Treatment at Scene

9.87%

18.23%

9.04%

10.70%

7.31%

8.54%

11.73%

6.48%

14.48%

4.81%

8.28%

0.00% 5.00% 10.00% 15.00% 20.00%

National Average

East Midlands

East of England

London

North East

North West

South Central

South East Coast

South Western

West Midlands

Yorkshire

% of Ambulance Calls Closed with Telephone Advice

36.99%

22.79%

37.42%

37.46%

36.09%

32.17%

40.08%

47.53%

49.07%

38.27%

30.22%

0.00% 10.00% 20.00% 30.00% 40.00% 50.00% 60.00%

National Average

East Midlands

East of England

London

North East

North West

South Central

South East Coast

South Western

West Midlands

Yorkshire

% of Ambulance Incidents Managed Without the Need for Transport to A&E


Target/

KPI

Rolling 12

MonthsFeb-16 Mar-16 Apr-16 May-16 Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Nov-16 Dec-16 Jan-17

24.00% 24.87% 29.01% 26.06% 24.83% 28.62% 26.06% 21.69% 25.57% 21.13% 23.55% 22.50% 23.14% 25.98%

45.00% 47.50% 53.33% 59.46% 55.00% 45.83% 50.00% 44.74% 33.33% 38.30% 47.06% 51.02% 48.72% 46.94%

84.00% 72.07% 71.20% 75.61% 79.34% 67.41% 67.48% 73.98% 71.43% 71.68% 75.82% 72.79% 67.96% 69.54%

90.00% 77.11% 88.81% 83.57% 82.38% 79.90% 71.18% 76.79% 80.68% 74.37% 72.57% 75.00% 77.11% 67.36%

57.00% 37.58% 46.12% 41.63% 36.67% 31.98% 32.54% 41.06% 34.30% 35.52% 35.26% 40.05% 35.14% 38.74%

97.00% 95.05% 96.33% 95.68% 95.17% 95.78% 95.39% 92.41% 93.81% 93.25% 94.76% 94.35% 97.07% 96.28%

9.00% 8.21% 8.41% 8.81% 9.15% 10.89% 8.63% 7.24% 6.62% 6.88% 10.18% 5.45% 8.14% 7.76%

27.00% 24.51% 25.00% 32.43% 25.64% 22.73% 26.09% 18.92% 18.18% 17.78% 27.08% 21.28% 34.29% 27.08%

Outcome from Stroke for Ambulance Patients - % of Face Arm Speech Test (FAST) positive stroke

patients (assessed face to face) potentially eligible for stroke thrombolysis, who arrive at a

hyperacute stroke centre within 60 minutes of call

Outcome from Stroke for Ambulance Patients - % of suspected stroke patients (assessed

face to face) who receive an appropriate care bundle

Outcome from Cardiac Arrest - Survival to Discharge - overall survival rate

Outcome from Cardiac Arrest - Survival to Discharge - Utstein Comparator Group survival

rate

Ambulance Clinical Indicators

Outcome from Cardiac Arrest - Return of Spontaneous Circulation at time of arrival at

hospital (overall)


hospital (Utstein Comparator Group)

Outcome from Acute ST-Elevation Myocardial Infarction (STEMI) - % of patients suffering a STEMI

and who, following a direct transfer to a PPCI centre, primary angioplasty commences within 150

minutes of call

Outcome from Acute ST-Elevation Myocardial Infarction (STEMI) - % of patients suffering a

STEMI and who receive an appropriate care bundle

0

50

100

150

200

250

300

350

400

0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

30.00%

35.00%

Outcome from Cardiac Arrest - Return of Spontaneous Circulation at Time of Arrival at Hospital

0

10

20

30

40

50

60

20.00%

25.00%

30.00%

35.00%

40.00%

45.00%

50.00%

55.00%

60.00%

65.00%

Outcome from Cardiac Arrest - Return of Spontaneous Circulation at Time of Arrival at

Hospital (Utstein Comparator Group)

0

20

40

60

80

100

120

140

160

180

50.00%

55.00%

60.00%

65.00%

70.00%

75.00%

80.00%

85.00%

90.00%

95.00%

Outcome from Acute STEMI - % of Patients Suffering a STEMI who, following a direct transfer to a PPCI

centre, primary angioplasty commences within 150 minutes of the call

0

50

100

150

200

250

300

50.00%

55.00%

60.00%

65.00%

70.00%

75.00%

80.00%

85.00%

90.00%

95.00%

Outcome from Acute STEMI - % of Patients Suffering a STEMI who Receive an Appropriate Care Bundle

0

100

200

300

400

500

600

20.00%

25.00%

30.00%

35.00%

40.00%

45.00%

50.00%

55.00%

60.00%

Outcome from Stroke - % of FAST Positive Stroke Patients, potentially eligible for Thrombolysis, who

arrive at Hyperacute Stroke Centre within 60 minutes

0

200

400

600

800

1,000

1,200

60.00%

65.00%

70.00%

75.00%

80.00%

85.00%

90.00%

95.00%

100.00%

Outcome from Stroke - % of Suspected Stroke Patients who Receive an Appropriate Care Bundle

0

50

100

150

200

250

300

350

400

0.00%

2.00%

4.00%

6.00%

8.00%

10.00%

12.00%

Outcome from Cardiac Arrest - Surival to Discarge Rate (Overall)

0

10

20

30

40

50

60

0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

30.00%

35.00%

40.00%

Outcome from Cardiac Arrest - Surival to Discarge Rate (Utstein Comparator Group)


PeriodNational

Average

East

Midlands

East of

EnglandLondon North East North West

South

Central

South East

Coast

South

Western

West

MidlandsYorkshire

Apr 16 to

Jan 1728.33% 24.81% 27.91% 29.18% 25.85% 35.56% 28.64% 27.64% 24.26% 30.29% 27.19%

Apr 16 to

Jan 1751.01% 48.12% 56.39% 53.20% 62.11% 56.74% 41.36% 52.00% 45.95% 46.48% 53.68%

Apr 16 to

Jan 1785.50% 91.09% 92.12% 90.04% 92.11% 79.53% 86.97% 89.69% 71.81% 86.62% 84.74%

Apr 16 to

Jan 1779.43% 84.05% 91.07% 71.34% 83.08% 86.93% 74.43% 66.93% 75.64% 80.61% 87.31%

Apr 16 to

Jan 1753.48% 52.53% 50.03% 61.51% 56.77% 52.68% 52.98% 62.50% 36.13% 57.91% 45.01%

Apr 16 to

Jan 1797.56% 98.71% 99.02% 96.59% 97.71% 99.68% 98.78% 95.77% 94.86% 97.03% 98.71%

Apr 16 to

Jan 178.29% 6.19% 7.86% 8.53% 7.35% 8.21% 12.61% 6.62% 8.12% 8.99% 9.90%

Apr 16 to

Jan 1726.71% 22.81% 28.72% 25.85% 35.75% 24.71% 24.52% 22.87% 23.79% 25.07% 35.27%

Outcome from Acute ST-Elevation Myocardial Infarction (STEMI) - % of patients suffering a STEMI

and who, following a direct transfer to a PPCI centre, primary angioplasty commences within 150

minutes of call

Outcome from Acute ST-Elevation Myocardial Infarction (STEMI) - % of patients suffering a

STEMI and who receive an appropriate care bundle

Outcome from Stroke for Ambulance Patients - % of Face Arm Speech Test (FAST) positive stroke

patients (assessed face to face) potentially eligible for stroke thrombolysis, who arrive at a

hyperacute stroke centre within 60 minutes of call

Outcome from Stroke for Ambulance Patients - % of suspected stroke patients (assessed

face to face) who receive an appropriate care bundle

Outcome from Cardiac Arrest - Survival to Discharge - overall survival rate

Outcome from Cardiac Arrest - Survival to Discharge - Utstein Comparator Group survival

rate


hospital (overall)


hospital (Utstein Comparator Group)

Ambulance Clinical Indicators - National Benchmarking

28.33%

24.81%

27.91%

29.18%

25.85%

35.56%

28.64%

27.64%

24.26%

30.29%

27.19%

0% 5% 10% 15% 20% 25% 30% 35% 40%

National Average

East Midlands

East of England

London

North East

North West

South Central

South East Coast

South Western

West Midlands

Yorkshire

Outcome from Cardiac Arrest - Return of Spontaneous Circulation at Time of Arrival at Hospital

51.01%

48.12%

56.39%

53.20%

62.11%

56.74%

41.36%

52.00%

45.95%

46.48%

53.68%

0% 10% 20% 30% 40% 50% 60% 70%

National Average

East Midlands

East of England

London

North East

North West

South Central

South East Coast

South Western

West Midlands

Yorkshire

Outcome from Cardiac Arrest - Return of Spontaneous Circulation at Time of Arrival at Hospital (Utstein Comparator

Group)

85.50%

91.09%

92.12%

90.04%

92.11%

79.53%

86.97%

89.69%

71.81%

86.62%

84.74%

50% 60% 70% 80% 90% 100%

National Average

East Midlands

East of England

London

North East

North West

South Central

South East Coast

South Western

West Midlands

Yorkshire

Outcome from Acute STEMI - % of Patients Suffering a STEMI who, following a direct transfer to a PPCI centre, primary angioplasty

commences within 150 minutes of the call

79.43%

84.05%

91.07%

71.34%

83.08%

86.93%

74.43%

66.93%

75.64%

80.61%

87.31%

50% 60% 70% 80% 90% 100%

National Average

East Midlands

East of England

London

North East

North West

South Central

South East Coast

South Western

West Midlands

Yorkshire

Outcome from Acute STEMI - % of Patients Suffering a STEMI who Receive an Appropriate Care Bundle

53.48%

52.53%

50.03%

61.51%

56.77%

52.68%

52.98%

62.50%

36.13%

57.91%

45.01%

0% 10% 20% 30% 40% 50% 60% 70%

National Average

East Midlands

East of England

London

North East

North West

South Central

South East Coast

South Western

West Midlands

Yorkshire

Outcome from Stroke - % of FAST Positive Stroke Patients, potentially eligible for Thrombolysis, who arrive at Hyperacute

Stroke Centre within 60 minutes

97.56%

98.71%

99.02%

96.59%

97.71%

99.68%

98.78%

95.77%

94.86%

97.03%

98.71%

70% 75% 80% 85% 90% 95% 100% 105%

National Average

East Midlands

East of England

London

North East

North West

South Central

South East Coast

South Western

West Midlands

Yorkshire

Outcome from Stroke - % of Suspected Stroke Patients who Receive an Appropriate Care Bundle

8.29%

6.19%

7.86%

8.53%

7.35%

8.21%

12.61%

6.62%

8.12%

8.99%

9.90%

0% 2% 4% 6% 8% 10% 12% 14%

National Average

East Midlands

East of England

London

North East

North West

South Central

South East Coast

South Western

West Midlands

Yorkshire

Outcome from Cardiac Arrest - Surival to Discarge Rate (Overall)

26.71%

22.81%

28.72%

25.85%

35.75%

24.71%

24.52%

22.87%

23.79%

25.07%

35.27%

0% 5% 10% 15% 20% 25% 30% 35% 40%

National Average

East Midlands

East of England

London

North East

North West

South Central

South East Coast

South Western

West Midlands

Yorkshire

Outcome from Cardiac Arrest - Surival to Discarge Rate (Utstein Comparator Group)



148,930 72,409 76,521 74,249 76,779 76,802 72,812 76,708 74,191 79,161 78,069 73,439 80,238

147,679 71,880 75,799 72,745 78,118 74,734 71,872 77,303 74,796 81,305 77,855 67,924 74,798

148,183 72,205 75,978

0.34% 0.45% 0.24%

150,593 73,135 77,458 75,226 79,076 77,220 73,770 78,127 76,532 84,074 79,885 74,047 80,227

-1.60% -1.27% -1.91%

A&E Incident Numbers

Actual A&E Incident Numbers 2015/16


Variance 2017/18 vs 2016/17

Contract A&E Incident Numbers 2017/18

Variance Actual vs Contract 2017/18


50,000

55,000

60,000

65,000

70,000

75,000

80,000

85,000



Actual A&E Incident Numbers 2015/16 Actual A&E Incident Numbers 2016/17

Actual A&E Incident Numbers 2017/18 Contract A&E Incident Numbers 2017/18

15,000

15,500

16,000

16,500

17,000

17,500

18,000

18,500

19,000

19,500

20,000

05

/01/2

01

5

19

/01/2

01

5

02

/02/2

01

5

16

/02/2

01

5

02

/03/2

01

5

16

/03/2

01

5

30

/03/2

01

5

13

/04/2

01

5

27

/04/2

01

5

11

/05/2

01

5

25

/05/2

01

5

08

/06/2

01

5

22

/06/2

01

5

06

/07/2

01

5

20

/07/2

01

5

03

/08/2

01

5

17

/08/2

01

5

31

/08/2

01

5

14

/09/2

01

5

28

/09/2

01

5

12

/10/2

01

5

26

/10/2

01

5

09

/11/2

01

5

23

/11/2

01

5

07

/12/2

01

5

21

/12/2

01

5

04

/01/2

01

6

18

/01/2

01

6

01

/02/2

01

6

15

/02/2

01

6

29

/02/2

01

6

14

/03/2

01

6

28

/03/2

01

6

11

/04/2

01

6

25

/04/2

01

6

09

/05/2

01

6

23

/05/2

01

6

06

/06/2

01

6

20

/06/2

01

6

04

/07/2

01

6

18

/07/2

01

6

01

/08/2

01

6

15

/08/2

01

6

29

/08/2

01

6

12

/09/2

01

6

26

/09/2

01

6

10

/10/2

01

6

24

/10/2

01

6

07

/11/2

01

6

21

/11/2

01

6

05

/12/2

01

6

19

/12/2

01

6

02

/01/2

01

7

16

/01/2

01

7

30

/01/2

01

7

13

/02/2

01

7

27

/02/2

01

7

13

/03/2

01

7

27

/03/2

01

7

10

/04/2

01

7

24

/04/2

01

7

08

/05/2

01

7

22

/05/2

01

7

All Ambulance Incidents per Week


4,163 3%

Bristol CCG 12,865

9%

Dorset CCG 22,659 15%

Gloucestershire CCG 14,904 10%

Kernow CCG 16,553 11%

NEW Devon CCG 25,507 17%

North Somerset CCG 5,709 4%

Somerset CCG 13,888

9%

South Devon & Torbay CCG 9,446 6%

South Gloucestershire CCG 5,885 4%

Swindon CCG 5,190 4%

Wiltshire CCG 11,067

8%

Ambulance Incidents by CCG Year to Date



4,163 2,065 2,098

12,865 6,279 6,586

22,659 11,180 11,479

14,904 7,232 7,672

16,553 8,016 8,537

25,507 12,310 13,197

5,709 2,776 2,933

13,888 6,817 7,071

9,446 4,591 4,855

5,885 2,888 2,997

5,190 2,457 2,733

11,067 5,425 5,642

347 169 178

148,183 72,205 75,978

2.31% 5.73% -0.85%

2.46% 1.26% 3.63%

-2.06% -1.24% -2.85%

-0.05% -1.30% 1.16%

0.02% 0.19% -0.14%

1.41% 2.02% 0.84%

4.73% 4.20% 5.24%

-2.31% -1.50% -3.07%

-1.24% 1.32% -3.56%

-1.34% -4.31% 1.70%

1.61% -1.29% 4.35%

2.99% 2.69% 3.28%

0.34% 0.45% 0.24%

-2.71% 0.39% -5.58%

0.07% 0.38% -0.23%

-4.17% -3.25% -5.04%

-2.27% -2.69% -1.87%

-0.46% -0.10% -0.79%

-0.74% -0.88% -0.61%

2.94% 2.97% 2.91%

-5.47% -4.47% -6.42%

-2.62% -3.39% -1.88%

-3.89% -2.04% -5.61%

-0.38% -2.65% 1.75%

0.91% 1.67% 0.20%

-1.60% -1.27% -1.91%



Swindon CCG



Dorset CCG

Gloucestershire CCG

Kernow CCG

Unknown CCG

NEW Devon CCG

North Somerset CCG

Somerset CCG

Wiltshire CCG

Trust Total

Gloucestershire CCG

Kernow CCG

Bristol CCG

Trust Total

A&E Incident Numbers % Variance Actual vs Contract 2017/18


Bristol CCG

Dorset CCG

NEW Devon CCG

North Somerset CCG

Somerset CCG



Swindon CCG


Swindon CCG

Wiltshire CCG

Trust Total

Gloucestershire CCG

Kernow CCG

NEW Devon CCG

North Somerset CCG

Somerset CCG


Wiltshire CCG

A&E Incident Numbers % Variance 2017/18 vs 2016/17


Bristol CCG

Dorset CCG


Target/


12.23% 12.20% 12.26%

35.35% 35.40% 35.30%

5.97% 5.85% 6.08%

46.45% 46.55% 46.36%

47.58% 47.60% 47.56%

53.55% 53.45% 53.64%


Source of A&E Incidents

97,726 47,323 50,403

19,423 9,272 10,151

31,034 15,610 15,424

148,183 72,205 75,978


Category of Incidents

7,808 3,769 4,039

8,271 4,090 4,181

50,805 24,488 26,317

35,071 17,372 17,699

17,093 8,388 8,705

13,501 6,637 6,864

4,493 2,179 2,314

6,844 3,308 3,536

4,297 1,974 2,323

148,183 72,205 75,978

A&E Incident Outcomes

Hear & Treat %

Public Incidents

HCP Incidents

% of Incidents Resolved Without Any Conveyance (Non Conveyance)

% of Incidents Resolved Without Conveyance to ED (Non Conveyance to ED)

See & Treat %

See & Convey Non ED %

See & Convey ED %

NHS 111 Incidents

Total

Category 1

Category 2R

Other

Total

Category 2T

Category 3R

Category 3T

Category 4H

Category 4T (999)

Category 4T (HCP)

Public Incidents 66%

HCP Incidents 13%

NHS 111 Incidents

21%

Source of A&E Incidents (YTD)

Hear & Treat % 12%

See & Treat % 35%

See & Convey Non ED %

6%

See & Convey ED %

47%

A&E Incident Outcomes (YTD) Category 1

5% Category 2R

6%

Category 2T 34%

Category 3R 24%

Category 3T 11%

Category 4H 9%

Category 4T (999) 3%

Category 4T (HCP)

5%

Other 3%

Category of A&E Incidents (YTD)



36,293 36,293 37,062 36,233 38,152 37,039 36,043 38,355 37,678 39,168 38,647 34,530 37,889

18,449 18,449 18,107 17,609 18,880 18,228 17,609 18,468 16,313 17,647 17,950 14,620 15,444

50.83% 50.83% 48.86% 48.60% 49.49% 49.21% 48.86% 48.15% 43.30% 45.05% 46.45% 42.34% 40.76%

2928:15 2928:15 2746:09 2646:05 2815:46 2633:43 2564:46 2732:28 2488:50 2781:18 2930:16 2150:31 2221:45

97:36 97:36 88:35 88:12 90:49 84:57 85:29 88:08 82:57 89:43 94:31 76:48 71:40

74,622 36,355 38,267

29,997 14,581 15,416

40.20% 40.11% 40.29%

4207:50 2036:04 2171:45

68:58 67:52 70:03

68,130 33,288 34,842

30,072 14,571 15,501

44.14% 43.77% 44.49%

5902:09 2880:44 3021:25

96:45 96:01 97:27

Total Operational Resources Hours Lost to Handover Delays in Excess of 15 Minutes 2016/17

Average Operational Resources Hours Lost to Handover Delays in Excess of 15 Minutes per Day 2016/17

Total Number of Handovers Recorded at Acute Hospitals 2016/17

Total Number of Handovers in Excess of 15 Minutes 2016/17

% of Handovers in Excess of 15 Minutes 2016/17

Total Number of Handover to Clears in Excess of 15 Minutes

% of Handover to Clear Times in Excess of 15 Minutes

Handover Delays

Total Number of Handovers Reported at Acute Hospitals 2017/18

Total Number of Handovers in Excess of 15 Minutes 2017/18

% of Handovers in Excess of 15 Minutes 2017/18

Total Operational Resources Hours Lost to Handover to Clear Delays in Excess of 15 Minutes

Average Operational Resources Hours Lost to Handover Delays in Excess of 15 Minutes per Day

Total Operational Resources Hours Lost to Handover Delays in Excess of 15 Minutes 2017/18


Handover to Clear Delays

Total Number of Handover to Clear Times Recorded at Acute Hospitals

0:00

12:00

24:00

36:00

48:00

60:00

72:00

84:00

96:00

108:00


Average Daily Operational Time Lost to Handover Delays at Hospitals in Excess of 15 Minutes



0:00

12:00

24:00

36:00

48:00

60:00

72:00

84:00

96:00

108:00


Average Daily Operational Time Lost to Handover to Clear Delays at Hospitals in Excess of 15 Minutes

Average Operational Resources Hours Lost to Handover Delays in Excess of 15 Minutes per Day



4,802 2,337 2,465

1,881 927 954

6,277 3,066 3,211

2,632 1,288 1,344

5,548 2,621 2,927

4,106 2,002 2,104

4,439 2,186 2,253

2,524 1,252 1,272

4,101 2,007 2,094

3,671 1,782 1,889

6,263 3,055 3,208

5,312 2,555 2,757

5,295 2,561 2,734

2,144 1,056 1,088

5,708 2,805 2,903

4,769 2,312 2,457

2,613 1,279 1,334

2,537 1,264 1,273

74,622 36,355 38,267


15:21 15:50 14:51

13:28 13:13 13:40

18:25 18:18 18:31

14:51 14:54 14:47

11:51 11:15 12:22

14:32 15:11 13:54

15:22 15:29 15:14

17:19 17:01 17:35

17:05 16:52 17:15

18:15 17:38 18:50

17:07 16:56 17:16

17:30 17:31 17:28

12:09 12:13 12:05

11:56 11:56 11:55

13:16 13:09 13:23

16:44 16:43 16:44

12:24 12:43 12:05

13:05 12:51 13:19

15:16 15:13 15:18

Number of Handovers by Acute Hospital

Bristol Royal Infirmary

Cheltenham General Hospital

Derriford Hospital

Dorset County Hospital

Gloucester Royal Hospital



Derriford Hospital



Great Western Hospital

Musgrove Park Hospital

North Devon District Hospital

Royal Devon & Exeter Hospital

Royal United Hospital Bath




Poole Hospital

Royal Bournemouth Hospital

Royal Cornwall Hospital

Average Handover Time per Incident (Mins:Sec)

Salisbury District Hospital

Southmead Hospital

Weston General Hospital

Yeovil District Hospital

Torbay Hospital

Total All Hospitals



Poole Hospital




Southmead Hospital

Torbay Hospital



Total All Hospitals



Operational Resource Hours Lost to Handover Delays in Excess of 15 Minutes (Hours:Mins)

330:20 174:57 155:22

78:14 37:29 40:45

544:38 263:41 280:57

122:18 61:03 61:14

158:35 71:01 87:34

249:50 140:30 109:20

230:10 115:28 114:42

191:15 89:07 102:08

271:50 128:34 143:16

313:12 134:50 178:21

424:46 198:49 225:57

374:43 180:11 194:31

112:15 51:05 61:10

74:09 35:02 39:06

233:20 111:10 122:09

341:48 162:33 179:14

88:58 48:40 40:17

67:22 31:48 35:34

4207:50 2036:04 2171:45

Target/


90.00% 91.70% 90.10% 91.70%

RAG Rating Green Green Green

90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90%

Other Metrics to be developed and included in future reports (when available):

Infection Prevention and Control Metrics (Quarterly)

Training Compliance (Annual Development Day and Training Workbook completion compared to plan)

Information Governance Toolkit Compliance

Derriford Hospital




Vehicle deep cleaning compliance with schedule (A&E)

Other Performance Metrics



Poole Hospital




Total All Hospitals

Southmead Hospital

Torbay Hospital







90.10% 91.70%

60.00%

65.00%

70.00%

75.00%

80.00%

85.00%

90.00%

95.00%

100.00%


Vehicle Deep Clean Compliance (A&E Vehicles)


Target/


15,083 6,959 8,124 6,090 6,960 6,566 5,686 6,541 5,824 8,596 7,514 6,294 6,436

16,209 8,803 7,406

7.47% 26.50% -8.84%

16,360 7,776 8,584 7,067 8,309 7,917 7,220 8,918 8,185 10,511 9,567 8,082 8,108

19,079 10,123 8,956

19,496 9,267 10,229

-2.14% 9.24% -12.45%

Out of Hours Patient Contacts

Dorset Out of Hours Patient Contacts - Actual 2016/17

Dorset Out of Hours Patient Contacts - Actual 2017/18

Percentage of Variance Year on Year - Dorset Out of Hours Patient Contacts

Percentage Actual vs Contract - Gloucestershire Out of Hours Patient Contacts

Gloucestershire Out of Hours Patient Contacts - Contract 2017/18

Gloucestershire Out of Hours Patient Contacts - Actual 2017/18

Gloucestershire Out of Hours Patient Contacts - Actual 2016/17

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

9,000

10,000


Dorset Out of Hours Patient Contacts

Actual 2017/18 Actual 2016/17

0

2,000

4,000

6,000

8,000

10,000

12,000


Gloucestershire Out of Hours Patient Contracts

Actual 2017/18 Actual 2016/17 Contract 2017/18


Target/


95.00% 92.09% 91.27% 93.13% 91.81% 90.94% 91.53% 90.97% 92.68% 94.82% 92.08% 90.43% 92.90% 93.25%

691 353 338

95.00% 88.28% 88.95% 87.57%

95.00% 85.50% 88.60% 86.38% 90.16% 87.65% 90.53% 84.02% 77.73% 88.19% 78.40% 79.76% 83.60% 92.11%

453 241 212

95.00% 89.85% 91.70% 87.74%

Target Call 95% 95% 95% 95% 95% 95% 95% 95% 95% 95% 95% 95%

Target/


95.00% 96.51% 93.77% 96.98% 95.76% 97.58% 98.28% 97.02% 97.75% 96.10% 94.56% 94.69% 97.41% 99.65%

1,556 839 717

95.00% 95.12% 94.04% 96.37%

95.00% 87.49% 90.56% 90.55% 94.70% 88.68% 90.62% 92.86% 88.02% 93.44% 72.38% 80.59% 81.57% 92.20%

849 460 389

95.00% 86.93% 82.61% 92.03%

Target Call 95% 95% 95% 95% 95% 95% 95% 95% 95% 95% 95% 95%

Dorset - % of Less Urgent Home Visits Completed within 6 Hours - 20117/18

Dorset - Number of Less Urgent Home Visits 2017/18

Dorset - % of Less Urgent Home Visits Completed within 6 Hours - 2016/17

Dorset - Number of Urgent Home Visits 2017/18

Gloucestershire - Number of Urgent Home Visits 2017/18

Out of Hours - Home Visits - Less Urgent Completed within 6 Hours

Gloucestershire - % of Less Urgent Home Visits Completed within 6 Hours - 20117/18

Gloucestershire - Number of Less Urgent Home Visits 2017/18

Gloucestershire - % of Less Urgent Home Visits Completed within 6 Hours - 2016/17

Dorset - % of Urgent Home Visits Completed within 2 Hours - 2016/17

Dorset - % of Urgent Home Visits Completed within 2 Hours - 20117/18

Gloucestershire - % of Urgent Home Visits Completed within 2 Hours - 2016/17

Gloucestershire - % of Urgent Home Visits Completed within 2 Hours - 20117/18

Out of Hours - Home Visits - Urgent Completed within 2 Hours

330

335

340

345

350

355

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

100.00%


Dorset Out of Hours - Urgent Home Visits Completed in 2 Hours

Dorset - Number of Urgent Home Visits 2017/18 % Completed in 2 Hours 2016/17 % Completed in 2 Hours 2017/18 Target

195

200

205

210

215

220

225

230

235

240

245

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

100.00%


Gloucestershire Out of Hours - Urgent Home Visits Completed in 2 Hours

Gloucestershire - Number of Urgent Home Visits 2017/18 % Completed in 2 Hours 2016/17

% Completed in 2 Hours 2017/18 Target

640

660

680

700

720

740

760

780

800

820

840

860

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

100.00%


Dorset Out of Hours - Less Urgent Home Visits Completed in 6 Hours

Dorset - Number of Less Urgent Home Visits 2017/18 % Completed in 6 Hours 2016/17


340

360

380

400

420

440

460

480

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

100.00%


Gloucestershire Out of Hours - Less Urgent Home Visits Completed in 6 Hours

Gloucestershire - Number of Less Urgent Home Visits 2017/18 % Completed in 6 Hours 2016/17



Target/


95.00% 89.83% 88.79% 88.81% 85.85% 89.00% 87.10% 87.37% 89.25% 94.02% 91.14% 93.63% 89.51% 90.73%

312 148 164

95.00% 92.31% 91.22% 93.29%

95.00% 92.56% 93.70% 94.72% 94.25% 90.98% 95.58% 93.51% 91.87% 93.71% 88.72% 90.11% 92.05% 92.73%

1,397 763 634

95.00% 90.69% 90.17% 91.32%

Target Call 95% 95% 95% 95% 95% 95% 95% 95% 95% 95% 95% 95%

Target/


95.00% 97.93% 97.21% 97.68% 98.03% 98.37% 98.33% 98.08% 98.32% 98.25% 97.36% 98.18% 97.72% 97.92%

5,930 3,200 2,730

95.00% 97.88% 97.53% 98.28%

95.00% 97.16% 97.32% 97.56% 97.31% 96.98% 96.74% 96.45% 97.73% 98.27% 96.03% 96.56% 98.47% 96.75%

3,906 2,077 1,829

95.00% 96.29% 95.09% 97.65%

Target Call 95% 95% 95% 95% 95% 95% 95% 95% 95% 95% 95% 95%

Dorset - % of Less Urgent Treatment Centre Completed within 6 Hours - 2016/17

Gloucestershire - % of Less Urgent Treatment Centre Completed within 6 Hours - 2017/18

Gloucestershire - Number of Less Urgent Treatment Centre Appointments 2017/18

Gloucestershire - % of Less Urgent Treatment Centre Completed within 6 Hours - 2016/17

Dorset - % of Less Urgent Treatment Centre Completed within 6 Hours - 20117/18

Dorset - % of Urgent Treatment Centre Completed within 2 Hours - 2016/17

Out of Hours - Treatment Centres - Urgent Completed within 2 Hours

Out of Hours - Treatment Centres - Less Urgent Completed within 6 Hours

Dorset - Number of Less Urgent Treatment Centre Appointments 2017/18

Gloucestershire - % of Urgent Treatment Centre Completed within 2 Hours - 20117/18

Gloucestershire - Number of Treatment Centre Appontments 2017/18

Gloucestershire - % of Urgent Treatment Centre Completed within 2 Hours - 2016/17

Dorset - % of Urgent Treatment Centre Completed within 2 Hours - 20117/18

Dorset - Number of Urgent Treatment Cente Appointments 2017/18

140

145

150

155

160

165

170

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

100.00%


Dorset Out of Hours - Urgent Treatment Centre Appointments Completed in 2 Hours

Dorset - Number of Urgent Treatment Cente Appointments 2017/18 % Completed in 2 Hours 2016/17


0

100

200

300

400

500

600

700

800

900

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

100.00%


Gloucestershire Out of Hours - Urgent Treatment Centre Appointments Completed in 2 Hours

Gloucestershire - Number of Treatment Centre Appontments 2017/18 % Completed in 2 Hours 2016/17


2,400

2,500

2,600

2,700

2,800

2,900

3,000

3,100

3,200

3,300

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

100.00%


Dorset Out of Hours - Less Urgent Treatment Centre Appointments Completed in 6 Hours

Dorset - Number of Less Urgent Treatment Centre Appointments 2017/18 % Completed in 6 Hours 2016/17 % Completed in 6 Hours 2017/18 Target

1,700

1,750

1,800

1,850

1,900

1,950

2,000

2,050

2,100

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

100.00%


Gloucestershire Out of Hours - Less Urgent Treatment Centre Appointments Completed in 6 Hours

Gloucestershire - Number of Less Urgent Treatment Centre Appointments 2017/18 % Completed in 6 Hours 2016/17 % Completed in 6 Hours 2017/18 Target


Target/


QR1 Compliance Compliant Compliant Compliant

QR2 95.00% 98.44% 98.29% 98.60%






QR10 95.00% n/a n/a n/a

QR10a 95.00% n/a n/a n/a

QR10a 95.00% n/a n/a n/a

QR10b 95.00% n/a n/a n/a

QR10d Compliance Compliant Compliant Compliant


QR12 95.00% n/an/a

(0 cases)

n/a

(0 cases)

QR12 95.00% 92.31% 91.22% 93.29%

QR12 95.00% 97.88% 97.53% 98.28%

QR12 95.00% n/an/a

(0 cases)

n/a

(0 cases)

QR12 95.00% 88.28% 88.95% 87.57%

QR12 95.00% 95.12% 94.04% 96.37%


Providers must operate a complaints procedure that is consistent with the

principles of the NHS complaints procedure

Providers must regularly audit a random sample of patients' experiences of

the service

Providers must regularly audit a random sample of patient contacts (audit

should provide sufficient data to review the clinical performance of each

individual working within the service)

Providers must have systems in place to support and encourage the regular

exchange of information between all those who may be providing care to

patients with predefined needs

Percentage of Out of Hours consultation details sent to the practice where

the patient is registered by 08:00 the next working day

Providers must report regularly to NHS Commissioners on their compliance

with the Quality Requirements

Emergency Consultations (presenting at base) started within 1 hour

Urgent Consultations (presenting at base) started within 2 hours

Less Urgent Consultations (presenting at base) started within 6 hours

Emergency Consultations (home visits) started within 1 hour

Patients unable to communicate effectively in English will be provided with

an interpretation service within 15 minutes of initial contact. Providers must

also make appropriate provision for patients with impaired hearing or

impaired sight

Less Urgent Consultations (home visits) started within 6 hours

Urgent Consultations (home visits) started within 2 hours

Providers must demonstrate their ability to match their capacity to meet

predictable fluctuations in demand for their contracted service

All immediately life threatening conditions (walk in patients) to be passed to

the ambulance service within 3 minutes of face to face presentation

Definitive Clinical Assessment for Urgent adult cases presenting at

treatment location to start within 20 minutes of arrival in the treatment centre

Definitive Clinical Assessmnet for children who are ill and have an urgent

Out of Hours to start within 15 minutes of arrival in the treatment centre

Definitive Clinical Assessment for Less Urgent cases presenting at


At the end of an assessment, the patient must be clear of the outcome

Providers must ensure that patients are treated by the clinician best

equipped to meet their needs in the most appropriate location

Out of Hours Contract Quality Requirements - Dorset


Target/



QR2 95.00% 99.85% 99.85% 99.85%






QR10 95.00% n/a n/a n/a

QR10a 95.00% 86.40% 86.27% 86.54%

QR10a 95.00% 77.98% 77.88% 78.10%

QR10b 95.00% n/a n/a n/a

QR10d Compliance Compliant Compliant Compliant


QR12 95.00% 69.57%71.43%

(14 cases)

66.67%

(9 cases)

QR12 95.00% 90.69% 90.17% 91.32%

QR12 95.00% 96.29% 95.09% 97.65%

QR12 95.00% 75.00%50.00%

(2 cases)

100.00%

(1 case)

QR12 95.00% 89.85% 91.70% 87.74%

QR12 95.00% 86.93% 82.61% 92.03%


Patients unable to communicate effectively in English will be provided with

an interpretation service within 15 minutes of initial contact. Providers must

also make appropriate provision for patients with impaired hearing or

impaired sight

Emergency Consultations (presenting at base) started within 1 hour

Urgent Consultations (presenting at base) started within 2 hours

Less Urgent Consultations (presenting at base) started within 6 hours

Emergency Consultations (home visits) started within 1 hour

Urgent Consultations (home visits) started within 2 hours

Less Urgent Consultations (home visits) started within 6 hours

Providers must ensure that patients are treated by the clinician best

equipped to meet their needs in the most appropriate location

Percentage of Out of Hours consultation details sent to the practice where

the patient is registered by 08:00 the next working day








the service





All immediately life threatening conditions (walk in patients) to be passed to

the ambulance service within 3 minutes of face to face presentation

Definitive Clinical Assessment for Urgent adult cases presenting at


Definitive Clinical Assessmnet for children who are ill and have an urgent

Out of Hours to start within 15 minutes of arrival in the treatment centre

Definitive Clinical Assessment for Less Urgent cases presenting at


At the end of an assessment, the patient must be clear of the outcome



Out of Hours Contract Quality Requirements - Gloucestershire


Target/


27,097 12,259 14,838 12,841 14,654 13,865 11,521 12,926 11,926 15,915 13,872 12,331 13,024

29,813 15,562 14,251

38,260 20,088 18,172 15,886 17,510 17,783 16,129 16,082 15,220 20,881 17,820 15,099 18,680

-22.08% -22.53% -21.58%

40,691 18,852 21,839 18,297 21,051 20,001 18,054 20,053 18,592 23,924 21,202 17,948 19,201

42,506 21,983 20,523

52,105 27,624 24,481 21,703 24,093 24,468 22,192 22,128 20,941 28,429 24,107 19,992 24,733

-18.42% -20.42% -16.17%

Target/


95.00% 75.21% 73.35% 61.13% 63.55% 53.94% 65.81% 93.46% 76.42% 75.70% 81.73% 83.37% 85.01% 88.74%

95.00% 84.59% 87.80% 81.08%

95.00% 83.18% 94.00% 82.07% 83.82% 75.80% 78.94% 85.23% 78.44% 76.57% 83.09% 84.97% 85.80% 89.57%

95.00% 86.32% 88.95% 83.44%

Target Call 95% 95% 95% 95% 95% 95% 95% 95% 95% 95% 95% 95%

NHS 111 - Cornwall Calls Offered - Contract 2017/18

NHS 111 - Cornwall Calls Offered - Actual 2017/18

NHS 111 - Cornwall Calls Offered - Actual 2016/17

NHS 111 - Dorset Calls Offered - Actual 2016/17

NHS 111 Call Answering in 60 Seconds

NHS 111 - Dorset Calls Offered - Actual 2017/18

NHS 111 - Dorset Calls Offered - Contract 2017/18

Percentage of Calls Offered - NHS 111 Dorset Actual vs Contract

NHS 111 Calls Offered

NHS 111 - Dorset - Percentage of Calls Answered in 60 Seconds 2017/18

NHS 111 - Dorset - Percentage of Calls Answered in 60 Seconds 2016/17

NHS 111 - Cornwall - Percentage of Calls Answered in 60 Seconds 2017/18

NHS 111 - Cornwall - Percentage of Calls Answered in 60 Seconds 2016/17

Percentage of Calls Offered - NHS 111 Cornwall Actual vs Contract

0

5,000

10,000

15,000

20,000

25,000


NHS 111 Cornwall Calls Offered


0

5,000

10,000

15,000

20,000

25,000

30,000


NHS 111 Dorset Calls Offered


40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

100.00%


NHS 111 Cornwall - % of Calls Answered in 60 Seconds

% Answered in 60 Seconds 2016/17 % Answered in 60 Seconds 2017/18 Target Call Answering Performance %

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

100.00%


NHS 111 Dorset - % of Calls Answered in 60 Seconds

% Answered in 60 Seconds 2016/17 % Answered in 60 Seconds 2017/18 Target Call Answering Performance %


Target/



QR2 95.00% 97.23% 97.34% 97.11%


QR4 CompliancePartially

Compliant

Partially

Compliant

Partially

Compliant

QR5 1.00% 0.17% 0.33% 0.00%



Compliant

Partially

Compliant

Partially

Compliant

QR8a 5.00% 2.83% 2.20% 3.52%

QR8b 95.00% 87.80% 87.80% 87.80%

QR9a 95.00% 100.00% 100.00% 100.00%

QR9b 95.00% 20.71% 18.39% 23.41%

QR13 95.00% 100.00% 100.00% 100.00%








the service







No more than 5% of calls abandoned before being answered

Calls to be answered within 60 seconds of the end of the introductory

message

All immediately life threatening conditions to be passed to the ambulance

service within 3 minutes

Patient callbacks must be achieved within 10 minutes

Patients unable to communicate effectively in English will be provided with an

interpretation service within 15 minutes of initial contact. Providers must also

make appropriate provision for patients with impaired hearing or impaired

sight

Providers must demonstrate that they are complying with the Department of

Health Information Governance SUI Guidance on reporting of Information

Governance incidents appropriately.

NHS 111 Contract Quality Requirements - Cornwall



Providers must send details of all consultations (including appropriate clinical

information) to the practice where the patient is registered by 8.00 a.m. the

next working day.

Providers must demonstrate the online completion of the annual assessment

of the Information Governance Toolkit at level 2 or above and that this is

audited on an annual basis by Internal Auditors using the national framework


Target/



QR2 95.00% 96.00% 94.86% 97.15%



Compliant

Partially

Compliant

Partially

Compliant

QR5 1.00% 0.30% 0.57% 0.00%



Compliant

Partially

Compliant

Partially

Compliant

QR8a 5.00% 2.22% 1.53% 2.95%

QR8b 95.00% 86.32% 88.95% 83.44%

QR9a 95.00% 95.92% 94.74% 96.67%

QR9b 95.00% 15.80% 13.79% 18.10%

QR13 95.00% 100.00% 100.00% 100.00%



Providers must send details of all consultations (including appropriate clinical

information) to the practice where the patient is registered by 8.00 a.m. the

next working day.

Calls to be answered within 60 seconds of the end of the introductory

message

No more than 5% of calls abandoned before being answered

NHS 111 Contract Quality Requirements - Dorset






the service







Providers must demonstrate that they are complying with the Department of

Health Information Governance SUI Guidance on reporting of Information

Governance incidents appropriately.

Patient callbacks must be achieved within 10 minutes

Patients unable to communicate effectively in English will be provided with an

interpretation service within 15 minutes of initial contact. Providers must also

make appropriate provision for patients with impaired hearing or impaired

sight

Providers must demonstrate the online completion of the annual assessment

of the Information Governance Toolkit at level 2 or above and that this is

audited on an annual basis by Internal Auditors using the national framework



All immediately life threatening conditions to be passed to the ambulance

service within 3 minutes


NHS 111 Sitrep Benchmarking

Target 06-Mar-16 13-Mar-16 20-Mar-16 27-Mar-16 03-Apr-16 10-Apr-16 17-Apr-16 24-Apr-16 01-May-16 08-May-16 15-May-16 22-May-16 29-May-16

95.00% 90.12% 91.19% 92.33% 87.99% 92.35% 92.60% 92.57% 90.21% 91.73% 89.97% 91.17% 83.25% 87.90%

95.00% 91.64% 88.95% 83.82% 90.36% 92.54% 84.26% 95.95% 79.19% 83.18% 88.45% 84.35% 66.81% 85.87%

95.00% 91.47% 89.89% 86.12% 90.27% 91.48% 86.41% 97.18% 82.70% 88.03% 86.18% 87.07% 70.46% 87.76%

95.00% 98.08% 98.92% 99.02% 96.91% 99.33% 99.81% 99.03% 98.80% 98.79% 98.51% 98.62% 97.93% 98.39%

95.00% 76.14% 77.81% 80.67% 72.17% 65.56% 65.75% 60.82% 65.75% 67.07% 66.39% 69.29% 61.22% 54.62%

5.00% 1.94% 1.77% 1.93% 2.84% 1.61% 1.59% 1.60% 2.11% 1.77% 2.43% 1.85% 3.14% 2.37%

5.00% 1.41% 1.98% 2.34% 1.29% 1.16% 2.48% 0.44% 5.04% 3.71% 1.98% 2.09% 6.57% 2.74%

5.00% 1.21% 1.53% 2.49% 1.18% 1.22% 1.82% 0.42% 2.52% 2.80% 2.14% 2.64% 4.29% 2.71%

5.00% 5.91% 5.81% 6.03% 9.41% 6.82% 6.31% 8.99% 16.72% 12.16% 14.62% 11.02% 18.41% 15.35%

5.00% 0.14% 0.00% 0.00% 0.14% 0.00% 0.00% 0.07% 0.06% 0.07% 0.28% 0.10% 0.19% 0.08%

13.37% 13.49% 13.39% 13.79% 13.55% 11.89% 13.01% 13.14% 13.18% 13.56% 13.60% 13.66% 14.02%

18.34% 15.80% 15.92% 15.97% 16.19% 15.69% 16.05% 16.43% 14.89% 15.47% 13.43% 16.24% 14.72%

17.63% 17.31% 15.49% 15.89% 17.06% 14.90% 14.82% 15.38% 14.72% 15.61% 12.95% 14.87% 16.66%

19.53% 21.92% 17.99% 20.27% 20.25% 18.24% 19.01% 20.64% 19.75% 20.88% 20.50% 20.19% 20.21%

0.48% 0.38% 0.52% 1.04% 0.91% 0.71% 1.89% 0.57% 0.62% 1.46% 1.00% 0.90% 1.24%

95.00% 39.39% 38.46% 39.73% 36.62% 39.79% 41.90% 43.83% 39.36% 41.10% 39.68% 38.73% 37.13% 40.36%

95.00% 14.11% 15.97% 15.02% 16.80% 15.86% 16.91% 23.90% 20.57% 25.10% 25.06% 25.00% 17.77% 23.25%

95.00% 11.79% 15.17% 16.53% 14.44% 14.99% 9.49% 18.17% 17.20% 21.18% 16.48% 21.57% 15.62% 14.01%

95.00% 84.83% 72.69% 80.93% 81.79% 74.30% 79.08% 85.45% 80.56% 78.59% 72.35% 79.76% 74.90% 78.34%

95.00% 5.88% 15.17% 15.02% 14.44% 14.99% 9.49% 18.17% 17.20% 15.38% 14.01% 14.29% 14.29% 14.01%

NHS 111 KPI Benchmarking - Weekly Sitrep Data - Call Answering

Percentage of Calls Answered in 60 Seconds - National Average

Week Commencing

Percentage of Calls Answered in 60 Seconds - Cornwall

Percentage of Calls Answered in 60 Seconds - Dorset

Percentage of Calls Answered in 60 Seconds - National Highest

Percentage of Calls Answered in 60 Seconds - National Lowest

NHS 111 KPI Benchmarking - Weekly Sitrep Data - Call Abandonment

Percentage of Calls Abandoned - National Average

Percentage of Calls Abandoned - Cornwall

Percentage of Calls Abandoned - Dorset

Percentage of Calls Abandoned - National Highest

Percentage of Calls Abandoned - National Lowest

Percentage of Call Backs in 10 Minutes - National Average

NHS 111 KPI Benchmarking - Weekly Sitrep Data - % of Call Backs Offered

Percentage of Call Backs Offered - National Average

Percentage of Call Backs Offered - Cornwall

Percentage of Call Backs Offered - Dorset

Percentage of Call Backs in 10 Minutes - Cornwall

Percentage of Call Backs in 10 Minutes - Dorset

Percentage of Call Backs in 10 Minutes - National Highest

Percentage of Call Backs in 10 Minutes - National Lowest

Percentage of Call Backs Offered - National Highest

Percentage of Call Backs Offered - National Lowest

NHS 111 KPI Benchmarking - Weekly Sitrep Data - Call Backs in 10 Minutes

40%

50%

60%

70%

80%

90%

100%

06-Mar-16 13-Mar-16 20-Mar-16 27-Mar-16 03-Apr-16 10-Apr-16 17-Apr-16 24-Apr-16 01-May-16 08-May-16 15-May-16 22-May-16 29-May-16

Weekly National NHS 111 Sitrep - % Calls Answered in 60 Seconds

National Average Cornwall Dorset Highest Lowest

0%

5%

10%

15%

20%

25%


Weekly National NHS 111 Sitrep - % of Call Backs Offered


0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

20%


Weekly National NHS 111 Sitrep - % Calls Abandoned


0%

10%

20%

30%

40%

50%

60%

70%

80%

90%


Weekly National NHS 111 Sitrep - % of Call Backs in 10 Minutes



Target/


2,834 1,331 1,503 1,280 1,431 1,254 1,266 1,249 1,112 1,216 1,168 1,111 1,293

2,757 1,321 1,436

2,781 1,425 1,356 1,405 1,392 1,392 1,343 1,274 1,235 1,212 1,240 1,177 1,505

-0.86% -7.30% 5.90%

Target/


2,701 1,316 1,385

2,688 1,312 1,376

95.00% 99.52% 99.70% 99.35%

2,759 1,316 1,443

2,717 1,294 1,423

95.00% 98.48% 98.33% 98.61%

Target Call 95% 95% 95% 95% 95% 95% 95% 95% 95% 95% 95% 95%

Tiverton UCC - Number of Cases 2017/18

Tiverton Urgent Care Centre

Tiverton Urgent Care Centre Activity - Actual 2016/17

Tiverton Urgent Care Centre Activity - Actual 2017/18

Tiverton Urgent Care Centre Activity - Contract Baseline 2017/18

Percentage Actual vs Contract - Tiverton Urgent Care Centre Activity

Tiverton Urgent Care Centre

Tiverton UCC - Number of Patients Seen within 4 Hours 2017/18

Tiverton UCC - % of Patients Seen within 4 Hours 2017/18

Tiverton UCC - Number of Cases 2017/18

Tiverton UCC - Number of Patients Triaged within 15 Minutes 2017/18

Tiverton UCC - % of Patients Triaged within 15 Minutes 2017/18

1,321 1,436

0

200

400

600

800

1,000

1,200

1,400

1,600


Tiverton Urgent Care Centre Activity


0

200

400

600

800

1,000

1,200

1,400

1,600

60.00%

65.00%

70.00%

75.00%

80.00%

85.00%

90.00%

95.00%

100.00%


Tiverton Urgent Care Centre - % of Patients Seen Within 4 Hours 2017/18

Tiverton UCC - Number of Cases 2017/18 Tiverton UCC - % of Patients Seen within 4 Hours 2017/18 Target

0

200

400

600

800

1,000

1,200

1,400

1,600

60.00%

65.00%

70.00%

75.00%

80.00%

85.00%

90.00%

95.00%

100.00%


Tiverton Urgent Care Centre - % of Patients Seen Within 4 Hours 2017/18

Tiverton UCC - Number of Cases 2017/18 Tiverton UCC - % of Patients Triaged within 15 Minutes 2017/18 Target


Staff Metrics - Establishment and Staff Turnover

Trust Summary- Staff Metrics


Trust Total Establishment - Actual WTE 3,868.27 3,867.65

Trust Total Establishment - Funded WTE 4,075.98 4,043.03

Variance -207.71 -175.38

Vacancy % -5.1% -4.3%

Support Services - Actual WTE 560.11 538.41

Support Services - Funded WTE 523.88 523.88

Variance 36.23 14.53

Vacancy % 6.9% 2.8%

Trust Total Staff Turnover


Turnover % (excl redundancies) 13.76% 13.37%

0

100

200

300

400

500

600


Support Services Establishment

Support Services - Funded WTE Support Services - Actual WTE

3,000

3,200

3,400

3,600

3,800

4,000

4,200


Trust Total Establishment

Trust Total Establishment - Funded WTE Trust Total Establishment - Actual WTE

13.76% 13.37%

0.00%

2.00%

4.00%

6.00%

8.00%

10.00%

12.00%

14.00%

16.00%

18.00%

20.00%


Trust - Staff Turnover (exc Redundancies)

Turnover % (excl redundancies)


A&E Operations Establishment


Lead Clinician - Actual WTE 1,622.72 1,615.59

Lead Clinician - Funded WTE 1,725.06 1,725.06

Variance -102.34 -109.47

Vacancy % -5.9% -6.3%

Support Clinician - Actual WTE 941.35 964.47

Support Clinician - Funded WTE 1,019.15 1,019.15

Variance -77.80 -54.68

Vacancy % -7.6% -5.4%

Total A&E Operations Establishment - Actual WTE 2,637.09 2,652.77

Total A&E Operations Establishment - Funded WTE 2,810.81 2,810.81

Variance -173.72 -158.04

Vacancy % -6.2% -5.6%

A&E Operations - Turnover



Turnover % (Lead Clinician) 11.77% 11.18%

Turnover % (Support Clinician) 9.06% 8.66%

1,000.00

1,100.00

1,200.00

1,300.00

1,400.00

1,500.00

1,600.00

1,700.00

1,800.00


A&E Operations - Lead Clinician Establishment

Lead Clinician - Funded WTE Lead Clinician - Actual WTE

500.00

600.00

700.00

800.00

900.00

1,000.00

1,100.00


A&E Operations - Support Clinician Establishment

Support Clinician - Funded WTE Support Clinician - Actual WTE

11.77% 11.18%

0.00%

2.00%

4.00%

6.00%

8.00%

10.00%

12.00%

14.00%

16.00%

18.00%

20.00%


A&E Operations - Lead Clinician Turnover

Turnover % (Lead Clinician)

9.06% 8.66%

0.00%

2.00%

4.00%

6.00%

8.00%

10.00%

12.00%

14.00%

16.00%

18.00%

20.00%


A&E Operations - Support Clinician Turnover

Turnover % (Support Clinician)


A&E Clinical Hub Establishment


Clinician- Actual WTE 63.99 65.46

Clinician - Funded WTE 76.00 76.00

Variance -12.01 -10.54

Vacancy % -15.8% -13.9%

Total A&E Clinical Hub Establishment - Actual WTE 402.41 409.48

Total A&E Clinical Hub Establishment - Funded WTE 413.72 413.72

Total Variance -11.31 -4.24

Vacancy % -2.7% -1.0%

A&E Clinical Hub - Turnover



0.00

10.00

20.00

30.00

40.00

50.00

60.00

70.00

80.00


A&E Clinical Hub - Clinician Establishment

Clinician - Funded WTE Clinician- Actual WTE

200.00

250.00

300.00

350.00

400.00

450.00


A&E Clinical Hub - Total Establishment

Total A&E Clinical Hub Establishment - Funded WTE Total A&E Clinical Hub Establishment - Actual WTE

21.60% 21.85%

0.00%

5.00%

10.00%

15.00%

20.00%

25.00%


A&E Clinical Hub - Staff Turnover (exc Redundancies)



UCS - Out of Hours Establishment


UCS Out of Hours Clinician - Actual WTE 42.74 42.47

UCS Out of Hours Clinician - Funded WTE 70.24 59.35

Variance -27.50 -16.88

Vacancy % -39.2% -28.4%

Total UCS Out of Hours Establishment - Actual WTE 144.48 143.85

Total UCS Out of Hours Establishment - Funded WTE 203.77 170.82

Variance -59.29 -26.97

Vacancy % -29.1% -15.8%

Out of Hours Service - Turnover (excl redundancies)

UCS Out of Hours - Turnover



0.00

10.00

20.00

30.00

40.00

50.00

60.00

70.00

80.00


UCS Out of Hours - Clinician Establishment

UCS Out of Hours Clinician - Funded WTE UCS Out of Hours Clinician - Actual WTE

0.00

50.00

100.00

150.00

200.00

250.00


UCS Out of Hours - Total Establishment

Total UCS Out of Hours Establishment - Funded WTE Total UCS Out of Hours Establishment - Actual WTE

25.47% 24.04%

0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

30.00%

35.00%

40.00%

45.00%


Out of Hours Service Staff Turnover (excl redundancies)



UCS - NHS 111 Establishment


NHS 111 Clinician - Actual WTE 27.11 27.11

NHS 111 Clinician - Funded WTE 27.50 27.50

Variance -0.39 -0.39

Vacancy % -1.4% -1.4%

Total NHS 111 Establishment - Actual WTE 124.17 123.13

Total NHS 111 Establishment - Funded WTE 123.80 123.80

Variance 0.37 -0.67

Vacancy % 0.3% -0.5%

NHS 111 Service - Turnover (excl redundancies)

NHS 111 Service - Turnover



0.00

5.00

10.00

15.00

20.00

25.00

30.00


NHS 111 - Clinician Establishment

NHS 111 Clinician - Funded WTE NHS 111 Clinician - Actual WTE

0.00

20.00

40.00

60.00

80.00

100.00

120.00

140.00


NHS 111 - Total Establishment

Total NHS 111 Establishment - Funded WTE Total NHS 111 Establishment - Actual WTE

38.90% 37.85%

0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

30.00%

35.00%

40.00%

45.00%


NHS 111 Service Staff Turnover (excl redundancies)



Staff Metrics - Sickness

Trust Total Sickness Abstraction % Support Services Sickness Abstraction %


Trust Total Long Term Sickness % 2.60% 2.74%

Trust Total Short Term Sickness % 2.07% 2.12%

Trust Total Sickness % 4.67% 4.86%

Trust Total Sickness KPI 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00%


Support Services Long Term Sickness % 1.95% 2.33%

Support Services Short Term Sickness % 1.14% 1.48%

Support Services Total Sickness % 3.09% 3.81%

Support Services Sickness KPI 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00%

A&E Operational Sickness Abstraction % A&E Clinical Hub Sickness Abstraction %

A&E Operations Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18

A&E Operations Long Term Sickness % 2.37% 2.61%

A&E Operations Short Term Sickness % 2.14% 2.03%

A&E Operations Total Sickness % 4.51% 4.64%

A&E Sickness KPI 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00%

A&E Clinical Hub Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18

A&E Clinical Hub Long Term Sickness % 4.16% 4.00%

A&E Clinical Hub Short Term Sickness % 2.75% 2.98%

A&E Clinical Hub Total Sickness % 6.91% 6.98%

A&E Sickness KPI 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00%

2.37% 2.61%

2.14% 2.03%

0.00%

1.00%

2.00%

3.00%

4.00%

5.00%

6.00%

7.00%

8.00%


A&E Operations Sickness %

A&E Operations Long Term Sickness % A&E Operations Short Term Sickness % A&E Sickness KPI

4.16% 4.00%

2.75% 2.98%

0.00%

1.00%

2.00%

3.00%

4.00%

5.00%

6.00%

7.00%

8.00%


A&E Clinical Hub Sickness %

A&E Clinical Hub Long Term Sickness % A&E Clinical Hub Short Term Sickness % A&E Sickness KPI

1.95% 2.33%

1.14%

1.48%

0.00%

1.00%

2.00%

3.00%

4.00%

5.00%

6.00%

7.00%

8.00%


Support ServicesSickness %

Support Services Long Term Sickness % Support Services Short Term Sickness % Support Services Sickness KPI

2.60% 2.74%

2.07% 2.12%

0.00%

1.00%

2.00%

3.00%

4.00%

5.00%

6.00%

7.00%

8.00%


Trust Total Sickness %

Trust Total Long Term Sickness % Trust Total Short Term Sickness % Trust Total Sickness KPI


UCS Out of Hours Sickness Abstraction % NHS 111 Sickness Abstraction %

UCS Out of Hours Service Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18

UCS Out of Hours Long Term Sickness % 3.02% 2.71%

UCS Out of Hours Short Term Sickness % 1.57% 1.45%

UCS Out of Hours Total Sickness % 4.59% 4.16%

UCS Out of Hours Sickness KPI 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00%

NHS 111 Service Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18

NHS 111 Service Long Term Sickness % 4.58% 3.12%

NHS 111 Service Short Term Sickness % 3.23% 4.85%

NHS 111 Service Total Sickness % 7.81% 7.97%

NHS 111 Service Sickness KPI 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00%

3.02% 2.71%

1.57% 1.45%

0.00%

2.00%

4.00%

6.00%

8.00%

10.00%

12.00%


UCS Out of Hours Sickness %

UCS Out of Hours Long Term Sickness % UCS Out of Hours Short Term Sickness % UCS Out of Hours Sickness KPI

4.58%

3.12%

3.23% 4.85%

0.00%

2.00%

4.00%

6.00%

8.00%

10.00%

12.00%


NHS 111 Sickness %

NHS 111 Service Long Term Sickness % NHS 111 Service Short Term Sickness % NHS 111 Service Sickness KPI


Staff Metrics - Staff Appraisal Completion %


Trust Total % Appraisals Completed 74.86% 69.32%

Support Services % Appraisals Completed 75.53% 55.10%

Appraisals Completion KPI 85.00% 85.00% 85.00% 85.00% 85.00% 85.00% 85.00% 85.00% 85.00% 85.00% 85.00% 85.00%


A&E Operations % Appraisals Completed 77.11% 72.67%

A&E Clinical Hub % Appraisals Completed 87.39% 78.81%


77.11% 72.67%

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

100.00%


A&E Operations - Appraisals Completed %

A&E Operations % Appraisals Completed Appraisals Completion KPI

87.39%

78.81%

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

100.00%


A&E Clinical Hub - Appraisals Completed %

A&E Clinical Hub % Appraisals Completed Appraisals Completion KPI

75.53%

55.10%

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

100.00%


Support Services Appraisals Completed %

Support Services % Appraisals Completed Appraisals Completion KPI

74.86% 69.32%

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

100.00%


Trust Total Appraisals Completed %

Trust Total % Appraisals Completed Appraisals Completion KPI



UCS Out of Hours % Appraisals Completed 38.77% 45.14%

NHS 111 Service % Appraisals Completed 57.52% 53.77%


38.77% 45.14%

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

100.00%


UCS Out of Hours - Appraisals Completed %

UCS Out of Hours % Appraisals Completed Appraisals Completion KPI

57.52% 53.77%

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

100.00%


NHS 111 - Appraisals Completed %

NHS 111 Service % Appraisals Completed Appraisals Completion KPI


A&E Service Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18

88 54

587 563

466 432

121 131

564 500

1,027 1,204

6 12

1 1

100% 80%

7 6

5 4

13 15

0 0

0 1

1 2

n/a n/a

75% 67%

17% 29%

Serious Incidents Currently Under Investigation

Never Events' Identified in Month (included in Serious Incidents figure above)

Number of Moderate Incidents confirmed in Month

Number of Moderate Incidents Under Investigation

Percentage of Moderate Incidents closed in the month which were investigated within 35 working days

Percentage of Moderate Incidents where contact has been made with the patient or relative (where this is possible) in accordance with the Duty of Candour

Percentage of Serious and Moderate Incidents where feedback has been completed within deadline, in accordance with Duty of Candour

Serious Incidents Investigated and Presented to Panel

Adverse Incidents reported relating to medication administration, prescription and supply errors

Number of Adverse Incidents Reported

Of the Adverse Incidents Reported:

Number of Adverse Incidents Reported Relating to the Trust

Number of Adverse Incidents Reported Relating to external services

Number of Adverse Incidents Closed

Number of Adverse Incidents Currently Under Investigation (as of last day of month)

Central Alert System (CAS) received

Central Alert System Warnings (outside deadline)

Percentage of Serious Incident investigations completed within 60 working days

Serious Incidents Identified in Month

587 563

88 54 0

100

200

300

400

500

600

700



Number of Adverse Incidents Reported Adverse Incidents reported relating to medication administration, prescription and supply errors

1,027

1,204

0

200

400

600

800

1,000

1,200

1,400


Number of Adverse Incidents Outstanding


6

12

1 1 0

2

4

6

8

10

12

14


Central Alert System (CAS)

Central Alert System (CAS) received Central Alert System Warnings (outside deadline)

100%

80%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


% of Serious Incidents Completed Within 60 Working Days


7

6

0

1

2

3

4

5

6

7

8


Number of Serious Incidents Identified in Month


13

15

0

2

4

6

8

10

12

14

16


Number of Serious Incidents Currently Under Investigation


0

1

0

1

2

3

4

5

6

7

8


Number of Moderate Incidents Confirmed in Month


1

2

0

1

2

3

4

5

6

7

8




75%

67%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


% of Moderate Incidents Where Contact is Made in Accordance with Duty of Candour

Percentage of Moderate Incidents where contact has been made with the patient or relative (where this ispossible) in accordance with the Duty of Candour

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


% of Closed Moderate Incidents Investigated Within 35 Working Days


A&E Service Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18

0 0

94 90

71 116

7 1

133 95

15 8

44 61

47 60

11 13

188 212

102 82

87 89

66 62

Safeguarding Referrals - it is a statutory duty for all organisations that work with children or vulnerable adults to share information, in a timely manner when abuse or neglect is identified or suspected.

Any staff member who has a concern about a vulnerable child or adult will complete a safeguarding referral that is submitted to the SWASFT safeguarding hub. This referral is then triaged and sent out to the relevant agency according to need i.e adult or child social services, GP, Fire, Police, CQC, Named Nurse etc.

963 1,118

Number of Security Incidents Closed (SIRS)(A&E Activity, Control, Operations, Fleet, Admin, Education & Training and Patient Safety Incidents)

Number of Security Incidents Currently Under Investigation (SIRS)(A&E Activity, Control, Operations, Fleet, Admin, Education & Training and Patient Safety Incidents)

Number of Safeguarding Referrals

The above figures can change on a daily basis as Complaints, Adverse Incidents and Serious Incidents are often recoded depending on the level of harm caused. Adverse Incidents, Moderate Incidents and Complaints can be deemed a Serious Incident and then downgraded to their original status, some complaints and

plaudits get logged after the report is generated depending on where they are receive in the Trust.

Number of Complaints where an investigation has been returned but the complainant is still awaiting feedback.

Total PALS Reported

Total PALS Closed

Total PALS Currently ongoing

Compliments Received

Number of Security Incidents Reported (SIRS)(A&E Activity, Control, Operations, Fleet, Admin, Education & Training and Patient Safety Incidents)

Number of Complaints Open (not resolved with the complainant and currently under investigation)

Number of Ombudsman referrals upheld

Number of Complaints Reported

Number of Complaints Closed (resolved with the Complainant and all investigations completed)

Number of Complaints Resolved (with the Complainant but internal investigation ongoing)

94 90

0

10

20

30

40

50

60

70

80

90

100




133

95

0

20

40

60

80

100

120

140


Number of Complaints Outstanding


15

8

0

2

4

6

8

10

12

14

16


Number of Complaints Where The Complainant is Awaiting Feedback


102

82

0

20

40

60

80

100

120


Number of Security Incidents Reported


66 62

0

10

20

30

40

50

60

70


Number of Security Incidents Under Investigation


963

1,118

0

200

400

600

800

1,000

1,200




44

61

0

10

20

30

40

50

60

70


Number of PALS Reported

Total PALS Reported

11

13

0

2

4

6

8

10

12

14


Number of PALS Outstanding


188

212

0

50

100

150

200

250


Number of Compliments Received


Out of Hours Service Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18

6 4

15 22

14 19

1 3

13 58

172 151

n/a 100%

0 0

1 1

1 0

0 0

0 0

0 0

n/a n/a

n/a n/a

n/a n/a


















15

22

6 4

0

5

10

15

20

25




100%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%




0 0 0

1

2

3

4

5

6

7

8




1

0 0

1

2

3

4

5

6

7

8




0 0 0

1

2

3

4

5

6

7

8




0 0 0

1

2

3

4

5

6

7

8




0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%




0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%




172

151

0

20

40

60

80

100

120

140

160

180

200




Out of Hours Service Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18

0 0

2 6

6 4

0 1

10 6

1 1

2 0

3 2

2 0

4 2

1 0

0 1

5 5



6 7












Total PALS Reported

Total PALS Closed




2

6

0

1

2

3

4

5

6

7

8




10

6

0

2

4

6

8

10

12




1 1

0

1

2

3

4

5

6

7

8




1

0 0

1

2

3

4

5

6

7

8




5 5

0

1

2

3

4

5

6

7

8




6

7

0

1

2

3

4

5

6

7

8




2

0 0

1

2

3

4

5

6

7

8



Total PALS Reported

2

0 0

1

2

3

4

5

6

7

8




4

2

0

1

2

3

4

5

6

7

8

9

10





0 0

20 20

15 15

5 5

15 58

282 248

n/a n/a

1 0

0 0

1 1

0 0

0 0

0 0

n/a n/a

0% n/a

n/a n/a


















20 20

0 0 0

5

10

15

20

25




0% 0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%




1

0 0

1

2

3

4

5

6

7

8




1 1

0

1

2

3

4

5

6

7

8




0 0 0

1

2

3

4

5

6

7

8




0 0 0

1

2

3

4

5

6

7

8




0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%




0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%




282

248

0

50

100

150

200

250

300





0 0

3 7

2 3

0 0

5 6

0 0

0 1

0 1

0 0

4 2

0 2

0 0

7 9



266 235









Total PALS Reported

Total PALS Closed







3

7

0

1

2

3

4

5

6

7

8




5

6

0

1

2

3

4

5

6

7




0 0 0

1

2

3

4

5

6

7

8




0

2

0

1

2

3

4

5

6

7

8




7

9

0

1

2

3

4

5

6

7

8

9

10




266

235

0

50

100

150

200

250

300




0

1

0

1

2

3

4

5

6

7

8



Total PALS Reported

0 0 0

1

2

3

4

5

6

7

8




4

2

0

1

2

3

4

5

6

7

8

9

10




Tiverton Urgent Care Centre Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18

0 0

1 2

1 1

0 0

1 1

6 9

n/a n/a

0 0

0 0

0 0

0 0

0 0

0 0

n/a n/a

n/a n/a

n/a n/a


















1

2

0 0 0

1

2

3

4

5

6

7

8

9

10




0% 0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%




0 0 0

1

2

3

4

5

6

7

8




0 0 0

1

2

3

4

5

6

7

8




0 0 0

1

2

3

4

5

6

7

8




0 0 0

1

2

3

4

5

6

7

8




0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%




0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%




6

9

0

1

2

3

4

5

6

7

8

9

10




Tiverton Urgent Care Centre Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18

0 0

0 2

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 1

0 0

0 0



2 1





Total PALS Closed











Total PALS Reported

0

2

0

1

2

3

4

5

6

7

8




0 0 0

1

2

3

4

5

6

7

8




0 0 0

1

2

3

4

5

6

7

8




0

1

0

1

2

3

4

5

6

7

8




0 0 0

1

2

3

4

5

6

7

8




2

1

0

1

2

3

4

5

6

7

8




0 0 0

1

2

3

4

5

6

7

8



Total PALS Reported

0 0 0

1

2

3

4

5

6

7

8




0 0 0

1

2

3

4

5

6

7

8

9

10




South Western Ambulance Service NHS Foundation Trust

Financial Performance - Summary Dashboard

Better Payment Practice Code KPI YTD Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18 Q1 Q2 Q3 Q4On

Target

Of

Concern

Action

Require

d

Better Payment Practice Code NHS (Value) % 95% 99.02% 97.33% 100.00% >95% <95%

Better Payment Practice Code NHS (Volume) % 95% 96.51% 96.67% 96.00% >95% <95%

Better Payment Practice Code Non NHS (Value) % 95% 99.66% 99.43% 99.83% >95% <95%

Better Payment Practice Code Non NHS (Volume) % 95% 99.15% 98.88% 99.38% >95% <95%

Other Key Financial Metrics KPI YTD Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18 Q1 Q2 Q3 Q4On

Target

Of

Concern

Action

Require

d

Debtors >90 Days Past Due as a % of Total Debtor Balances 5.00% 9.35% 8.61% 9.35% <5% >5%

Creditors >90 Days Past Due as a % of Total Creditor

Balances5.00% 0.64% 0.48% 0.64% <5% >5%

Capital Expenditure as a % of Plan (Min)

(YTD position reported each month)85.00% 96.08% 100.58% 96.08% >85% <85%

Cost Improvement Programme (CIP) as a % of Plan

(YTD position reported each month)85.00% 100.00% 100.00% 100.00% >85% <85%

Single Oversight Framework - Use of Resources KPI YTD Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18 Q1 Q2 Q3 Q4

Capital Service Capacity (times) 1.00

6.8 times

1.00

6.5 times

1.00

Liquidity (days) 1.00

8.4 days

1.00

7.9 days

1.00

I&E Margin (%) 2.00

0.01%

2.00

0.00%

2.00

Variance in I&E Margin as % of Plan 1.00

0.00%

1.00

0.00%

1.00

Agency Metric 1.00 1.00 1.00

Use of Resources Metric 2.00 2.00 2.00

Comments:



Financial Performance - Statement of Comprehensive Income

Statement of Comprehensive Income Actual Budget Variance Actual Budget Variance

Period Ending 31/05/2017

Month 2

£'000 £'000 £'000 £'000 £'000 £'000

Income:

A&E Income (32,443) (32,441) (1) (194,656) (194,645) (12)

UCS Income (3,632) (3,457) (175) (14,714) (14,300) (414)

PTS Income (11) (4) (7) (32) (25) (7)

HART Income (1,109) (1,109) - (6,652) (6,652) -

Other Income (2,474) (2,029) (445) 2 (13,304) (11,003) (2,301) 2

Total Income (39,668) (39,040) (628) (229,358) (226,625) (2,733)

Expenditure:

Employee Benefits (Pay) 29,547 29,643 (96) 1,2 170,635 171,087 (452) 1,2

Drugs 88 117 (29) 522 484 38

Medical 939 780 159 4,940 4,622 318

ICT 1,066 1,022 44 3 6,346 5,880 465 3

Estates 1,239 1,200 38 7,149 7,001 148

Fleet Expenses 765 737 28 4,509 4,413 96

Fuel 965 958 8 5,692 5,724 (32)

Vehicle Insurance 348 358 (10) 2,107 2,142 (36)

Vehicle Leasing 148 106 42 824 636 188

Education & Training 143 140 3 1,130 840 290

Other 2,026 1,479 548 1 10,753 8,847 1,906 1

Total Operating Expenses 37,275 36,541 734 2 214,606 211,677 2,929 2

EBITDA (2,393) (2,499) 106 (14,752) (14,948) 196

EBITDA % 6.0% 6.4% 6.4% 6.6%

Profit/Loss on Asset Disposal - - - - - -

Depreciation 2,040 2,078 (38) 12,334 12,372 (38)

Impairments - - - - - -

Total Operating (Surplus)/Deficit (353) (421) 68 (2,416) (2,576) 160

Total Interest Receivable (7) (8) 1 (44) (43) (1)

Total Interest Payable 14 20 (6) 105 120 (15)

PDC Dividend 347 409 (62) 2,355 2,499 (144)

Net (Surplus)/Deficit 0 - (0) (0) 0 0

Comments:

1 Use of third parties offset vacancies in A&E;

2 Other income above plan offset by additional expenduiture

3 ICT spend variance is due ECS IT costs matched by income.

Year to Date Forecast



Financial Performance - Statement of Financial Position

31-Mar-17

Statement of Financial Position Actual Actual Budget Variance Actual Budget Variance

Period Ending 31/05/2017

Month 2

£'000 £'000 £'000 £'000 £'000 £'000 £'000

Non-Current Assets

Property, Plant & Equipment & Intangible Assets, Net 87,531 88,034 89,162 (1,128) 1 89,579 90,603 (1,024)

Trade & Other Receivables Non-Current 85 82 10 72 28 - 28 -

Total Non-Current Assets 87,616 88,116 89,172 (1,056) 89,607 90,603 (996)

Current Assets -

Inventories 2,288 2,241 2,266 (25) 2,276 2,276 -

NHS Trade Receivables, Current 721 1,304 2,904 (1,600) 2 1,750 1,750 -

Non NHS Trade Receivables, Current 858 356 482 (126) 2 550 550 -

Other Receivables, Current 722 657 812 (155) 1,241 1,302 (61)

Prepayments, Current, Non-PFI related 1,852 3,957 3,027 930 3 1,850 2,575 (725)

Other Financial Assets, Current 62 2,071 1,403 668 4 79 79 -

Cash and Cash Equivalents 27,406 23,187 19,110 4,077 5 19,277 17,349 1,928 -

Current Assets 33,909 33,773 30,004 3,769 27,023 25,881 1,142

Non Current Assets Held for Sale 168 - - - - - -

Total Current Assets 34,077 33,773 30,004 3,769 27,023 25,881 1,142

TOTAL ASSETS 121,693 121,889 119,176 2,713 116,630 116,484 146

Current Liabilities -

Deferred Income (558) (834) (684) (150) (297) (297) -

NHS Trade Payables (333) (178) (50) (128) 6 (200) (200) -

Non-NHS Trade Payables (3,052) (3,210) (1,800) (1,410) 6 (2,150) (2,150) -

Capital Accruals (2,221) (1,564) (2,520) 956 7 (1,286) (1,386) 100

Other Liabilities (5,995) (6,014) (5,715) (299) (5,106) (5,800) 694

Borrowings (467) (467) (468) 1 (439) (439) -

Other Financial Liabilities (10,116) (11,320) (8,533) (2,787) 8 (10,693) (9,364) (1,329)

PDC Dividend Payable, Current - (295) (409) 114 - - -

Provisions for Liabilities and Charges (3,578) (2,835) (3,175) 340 9 (1,110) (849) (261) - -

Total Current Liabilities (26,320) (26,717) (23,354) (3,363) (21,281) (20,485) (796)

Net Current Assets/(Liabilities) 7,757 7,056 6,650 406 5,742 5,396 346

TOTAL ASSETS LESS CURRENT LIABILITIES 95,373 95,172 95,822 (650) 95,349 95,999 (650)

Non-Current Liabilities -

Finance Leases, Non-Current (613) (614) (613) (1) (614) (613) (1)

Long Term Borrowings (1,290) (1,290) (1,290) - (862) (862) -

Other Financial Liabilities, Non-Current - - - - - - -

Provisions, Non-Current (4,174) (3,972) (3,997) 25 9 (4,077) (4,102) 25

Trade and Other Payables, Non-Current - - - - - - - -

Total Non-Current Liabilities (6,077) (5,876) (5,900) 24 (5,553) (5,577) 24

TOTAL ASSETS EMPLOYED 89,296 89,296 89,922 (626) 89,796 90,422 (626)

Represented By

Public Dividend Capital 43,025 43,025 43,025 - 43,025 43,025 -

Income & Expenditure Account 36,345 36,506 36,679 (173) 10 36,853 37,026 (173)

Revaluation Reserve 9,926 9,765 10,218 (453) 11 9,918 10,371 (453)

TOTAL TAXPAYERS EQUITY 89,296 89,296 89,922 (626) 89,796 90,422 (626)

Comments:1 Property, Plant and Equipment - Begind plan due to 2016/17 - Capital spend (£265k) behind forecast, DV Revaluation (£364k) less than forecast, impairment (£267k) more than forecast and Carbis Bay (£168k) not forecast to be sold = (£1,064k).

2017/18 Capital ahead of plan £6k, depreciation £20k behind plan = (£66k) = (£1,130k)

2 NHS Trade Receivables, Current - ahead of plan, which was based on 2016/17 actuals.

3 Prepayments - Rent and ICT above plan and faster payment for dilapidations (from provisions) not allocated by SBS at month end.

4 Other Financial Assets - High winter pressure, salary recharges and CQUINs.

5 Cash - Prepayments and Other Assets ahead of plan (£1,598k), Recivables better than plan £1,880k, Trade Payables, Other Financial Liabilities and Deferred income more than plan £4,775k,

Provisions & capital accruals less than plan (£1,321k) & 2016/17 outturn £267k more = £4,003k

6 Non-NHS Trade Payables - More invoices outstanding for payment than plan.

7 Capital accruals - Fleet vehicles delivered not yet paid.

8 Other Financial Liabilities - More accruals than plan for Pay, medical gases, ICT, Fleet, Estates and ARP.

9 Provisions - Dilapidations for Acuma paid earlier than plan.

10 Income & Expenditure:- 2016/17 deficit £393k compared to plan deficit £131k = £262k, excess depreciation (£90k) more than plan due to disposal of Carbis Bay = £172k

11 Revaluation Reserve:- 2016/17 revaluation forecast (£364k) more than DV valuation 2016/17 out turn and (£90k) for disposal of Carbis Bay = (£454k)

Year to Date Forecast


integrated corporate performance report may 2017 · page 4 of 7 aqi metric jun-16 jul-16 aug-16...

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